Quality not accreditation…or argumentum ad verecundiam?


 Argument from authority – it’s not always wrong…


Toyota for you doc, what will it be for your patients?

In a recent Medscape survey it was found that doctors’ choice of cars were as follows: Toyota (16.73%), Honda (14.8%), Lexus (8.3%), BMW (7.5%), and Mercedes-Benz (5.32%). Ford came in a very close sixth at 5.24%, and Chevrolet came in eighth at 4.13%.

It is apparent that 25% of doctors chose Toyota directly (since Lexus is manufactured by Toyota) and 31.53% come from the the lean methodology (since Honda also follows similar methods) constituting the top two car choices of American doctors. If other Japanese manufacturers were included it would be much more. It is a 2012 survey that means the doctors were probably aware of Toyota’s problems from 2010.

Why would doctor’s chose cars manufactured with lean methodology despite Toyota’s recent problems? It is possible that the doctors feel those cars are still highly reliable despite the odd headline problems. The doctors are perhaps really impressed with the degree of honesty with which Toyota has recalled to rectify problems and the degree of humility shown in offering a public world wide apology. It may be the case that Toyota, Honda and those who share their lean philosophy still offer great value for money – doctors also do look for value for money.

What is fascinating is that the majority of doctors, the same doctors who like Toyota lean methodology despite its problems, do not follow the healthcare adaptations of lean methodology despite undeniably proven examples within America. Virginia Mason is a small scale system and Intermountain is a large scale system that has excellent versions of clinical lean (there are others too). There is huge resistance to even begin to look at the methodology.

Human beings and healthcare, are not cars and car manufacturing, so I do understand if we did not want industry people directly applying their methods to healthcare. Clinical lean and healthcare delivery lean is specific and different (as practised at a few places in the world), the translation and adaptation has already been done and fine tuned for nearly a quarter of a century. Clinicians need to show the relevant leadership to make it work in their patch where ever they are in the world.

It is not too much to ask is it, to deliver value to your patient; the same or more value that you expect from your car? I know patients are not cars and healthcare is godzillion times more complex that the automotive industry. That is why I talk about value creation and the application of healthcare specific lean (not other industry lean) from proven systems. Clinicians only have to learn and apply clinical lean in healthcare – if you can learn and practice medicine with all its complexity, applying clinical lean where possible, with its eventual elegant simplicity is a piece of cake. Or is it?

©M HEMADRI

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