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Why A Individual Mightiness Or Mightiness Non Desire Their Wellness Tending To Resemble A Repast At The Cheesecake Factory--A Reply To Atul Gawande

When I drive downwardly a street too encounter exclusively national chain restaurants too retail stores, I am sad. Can nosotros create no improve than this, to brand everything the same, supporting surely foods, surely products at the expense of the tremendous multifariousness of such things that exist?

Atul Gawande simply wrote a rattling compelling article in which he explored the chain eating seat The Cheesecake Factory equally a model or metaphor for goodness wellness care.  He non exclusively ate there, but toured the facility too observed the processes that permit this huge house to furnish nutrient that is interesting, delicious too affordable. His master copy thesis is that an manufacture that standardizes fantabulous practices tin furnish high lineament care, too that it is non unthinkable that medicine could last substantially improved yesteryear adopting such a model. He also looked at about fantabulous hospitals that conduct hold begun to standardize such things equally patient attention inwards the ICU too sum human knee replacements.

There are many things that, through scientific inquiry, are known to last VERY GOOD IDEAS. Things similar preventing blood clots inwards the legs alongside surely medications, elevating the caput of the bed of patients on ventilators to forestall pneumonia, treatment key venous catheters inwards such a means equally to avoid catheter infections tin relieve lives too should last done routinely. There are surely practices that are agreed to last "best practices" yesteryear either evidence or practiced opinion, such things equally maintaining repose inwards patient attention areas, numbing upwards arterial puncture sites, preserving normal slumber wake cycles, which significantly improve lineament of attention for patients. Both inpatient too outpatient medicine are positively crawling alongside "best practices."

Surgery is a champaign that is absolutely ripe for protocol driven procedures, because too so many things tin larn incorrect when a mortal is anesthetized too cutting open, too and so many things must last remembered too performed perfectly too quickly. Atul Gawande is a surgeon. His checklists (see his book, The Checklist Manifesto) assay to brand the multiple complexities of practicing medicine too surgery easier to navigate.

The Cheesecake Factory is a fully realized existent the world illustration of good performed standardized processes, too hence to a greater extent than delicious fifty-fifty than checklists. I am oftentimes frustrated equally I watch, via medical charts, the multifariousness of inattentive too thoughtless medicine that passes for OK inwards hospitals too clinics. It would last genuinely overnice if everybody knew too could exercise inwards a means that genuinely made feel when at that spot is genuinely believable evidence to back upwards these processes. In addition, I oftentimes break myself surgical operation at the rattling border of my abilities due to the complex coordination of what seems to last almost interplanetary space information inwards the setting of existent patients genuinely getting super sick too flirting alongside death. In these situations I long for processes that larn inwards slow for me to last smart or impossible for me to last rattling stupid. I await for computers to assistance me focus on the of import information too remind me when I forget something that needs to last done. I await for nurses to pay attending to things that were, at about dot inwards the past, the private realm of doctors, such equally tests too medication interactions too recommended prevention strategies.

But I don't desire medical attention to resemble a repast at the Cheesecake factory, though I hear the salmon is delicious.

Much of medicine is practiced on people who are equally dissimilar from each other too equally private equally snowflakes. My patients are never the same equally 1 another, too the problems too stories they convey me require of me a dissimilar responses based on too so rattling many things. Influenza A virus subtype H5N1 patient mightiness come upwards inwards alongside a numb toe, having of late split upwards from her husband, alongside a lump inwards her throat. Or he mightiness come upwards inwards alongside "heartburn" too Asperger's syndrome too a notable suspicion of the medical profession. Not exclusively are the possible diagnoses for each of these people myriad, too so are the ways I mightiness kickoff to investigate them too the ways I mightiness care for them spell waiting for to a greater extent than data. These are the existent patients who are hard to care for alongside "evidence based medicine" since nobody always did a study on them looking at what worked too what did not, because each 1 is unique.

When a physician is encouraged to usage protocols too pathways inwards treating patients, he or she is tempted to forcefulness patients into artificial categories which Pb to these protocols. Patients know when this is happening too they experience similar herd animals, too they experience non beingness listened to. And however I am non against pathways too protocols inwards full general since they tin assistance us avoid about egregious mistakes too obscene waste. The trick, I think, is to avoid beingness also impressed alongside The Cheesecake Factory, to usage protocols inwards situations where they genuinely are indicated too to save a feel of inventiveness too curiosity when faced alongside existent people alongside genuinely interesting problems.
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