Misleading as it may seem, Taylorism in the context of medical care can be threatening. And make no mistake, we know that Frederick Winslow Taylor wrote the most influential book on management: Principles of Scientific Management. Since his book came out more than a century ago, business owners around the world, Toyota included, have embraced Taylor's approach. He believed in devising a system as machinelike as possible, a factory assembly line as standardized as possible, a conveyor belt as precisely timed as possible.
Does this sound familiar to the clinical pathway, also known as integrated care pathway, in the healthcare system? Believe me when I say they are.
Keep that image of Toyota manufacture factory in your mind. Each of the factory employees work repetitively, precisely and strategically. To do this in the clinic, we can have a standardized electronic health record like Toyota. Press a button when a diabetic patient enters the consultation room, and presto, the computer will have a template consultation page prepared automatically. The doctor won't even have to type extra keystroke to have all the laboratory results filled in the boxes.
I can't tell you how many times I have deliberately deleted all those templates and came up with my own paragraphs in the clinic notes. Ask Jerome Groopman, and he will tell you Taylorism doesn't work in human patients. "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."
In other words, none of our patients want to be treated like a Toyota car. None. Zip. Never.
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