New Yorker — Atul Gawande: Can Hospital Chains Improve the Medical Industry?
Restaurant chains have managed to combine quality control, cost control, and innovation. Can health care?
Big chains thrive because they provide goods and services of greater variety, better quality, and lower cost than would otherwise be available.
Medicine, though, had held out against the trend. Physicians were always predominantly self-employed, working alone or in small private-practice groups. American hospitals tended to be community-based. But that’s changing. Hospitals and clinics have been forming into large conglomerates. And physicians—facing escalating demands to lower costs, adopt expensive information technology, and account for performance—have been flocking to join them. According to the Bureau of Labor Statistics, only a quarter of doctors are self-employed—an extraordinary turnabout from a decade ago, when a majority were independent. They’ve decided to become employees, and health systems have become chains.
See on www.newyorker.com
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