Bioethics News

Is US medicine becoming an assembly line?

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Frederick Taylor (1856-1915), one of the first management consultants, helped to make American manufacturing great by discovering the most effective and time-saving way of directing employees to their work. “In the past, the man has been first; in the future, the system must be first” summarises his philosophy.

Two physicians from Beth Israel Deaconess Medical Center and Harvard Medical School in Boston complain in the latest New England Journal of Medicine that “Taylorism has begun permeating the culture of medicine” with the implementation of electronic health records. Here are excerpts from their attack on what they believe to be a drive to treat patients like cars on an assembly line:

Physicians sense that the clock is always ticking, and patients are feeling the effect. One of our patients recently told us that when she came in for a yearly “wellness visit,” she had jotted down a few questions so she wouldn’t forget to ask them. She was upset and frustrated when she didn’t get the chance: her physician told her there was no time for her questions because a standardized list had to be addressed — she’d need to schedule a separate visit to discuss her concerns.

We believe that the standardization integral to Taylorism and the Toyota manufacturing process cannot be applied to many vital aspects of medicine. If patients were cars, we would all be used cars of different years and models, with different and often multiple problems, many of which had previously been repaired by various mechanics. Moreover, those cars would all communicate in different languages and express individual preferences regarding when, how, and even whether they wanted to be fixed.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.