Today is the age of big: big pharmaceutical companies, big agricultural conglomerates, big retailers and big food chains. However, many are starting to ask questions about the quality of product that Big delivers. Is your meal better at a local restaurant where the chef and the owner are the same woman vs. a national chain? Does your produce taste better when it comes from a farm 50 miles from your house vs. being shipped from another continent? Does your local hardware store provide better service than a national chain?
Perhaps it is time we started asking questions about big medicine. While large healthcare organizations can do certain things well – integrated care for complex diseases and research, for example – are they really best suited to outpatient medicine and community care? Are they cost effective? When physicians are employees who punch the clock, instead of owners with a vested interest in the long-term success of the practice, do they care equally?
As a small business owner I work alongside my staff in the same type of cubicle everyday. If there is a new study showing that we need to change practice we can have our protocols adjusted that afternoon. If I have an unhappy patient I have the full authority to do what is necessary to ‘make it right.’ We run incredibly lean processes that would make even a six-sigma blackbelt jump with joy; this allows us to provide the highest quality medical care at a fraction of the cost. Finally, all of my surgical patients go home with my cell phone number – not the resident on call pager.
When it comes time to choose your physician ask whether bigger is really better for you and your family.
-Neil A. Shah, MD, FAAD