When I teach lean overview training in healthcare settings, it’s often tough to find examples of the Waste of “Overprocessing,” one of the types of waste that Toyota has defined and popularized as lean has spread.
The article I linked to above is a sad example of a doctor doing more work than the customer needs or values., the definition of overprocessing.
“A federal lawsuit filed by a heart patient and a doctor accuses Saint Edward Mercy Medical Center and a surgeon of performing unnecessary heart surgeries to defraud Medicare and other federal health programs.”
When our health care system (“disease care” as some call it) pays doctors and organizations for the work they do, isn’t this just like “piece work” pay in the manufacturing world? The temptation is there to do unnecessary work — thankfully, most doctors don’t succumb to that temptation, right?
I recorded a future LeanBlog Podcast interview with David Mann (author of the outstanding book Creating a Lean Culture) on Sunday and he talked about how Steelcase moved away from piece work pay. Paying employees for what they produce (as opposed to what customers need) leads to overproduction and all sorts of waste (inventory, defects, waiting, etc.). Piece work isn’t a lean method and most lean companies move away from piece work pay to hourly pay (with bonuses and variable compensation for company performance and/or reaching operational goals).
I guess it’s too hard to pay healthcare providers for their results (you being healthy), rather than paying them for the things they do and the things they use in the course of treating you and your ilnesses. A doctor doesn’t get paid for PREVENTING illness. It seems like moving away from piece work healthcare would sure help (even if it’s a Quixotic goal).
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