Fogarty's Narrative Matters essay (Nov 2011) was neither an assembly line nor efficient. Her problems with scheduling should be the first clue, but the wait times are the defining metric. No "efficient" setup would tolerate those. Like most of health care, this was a "job shop": We do one of these, then one of those, then one of something else. This is inherently inefficient. An efficient operation would group like things together, doing all mammograms in the morning, all ultrasounds on Tuesday, and so on. The presence of a waiting room indicates an inefficient scheduling process. With open-access scheduling, there is no waiting time for patients or providers.
展开▼
