Atul Gawande outlines ways that medicine can look to chains like the Cheesecake Factory for quality and efficiency

In an article in the New Yorker, physician Atul Gawande states that medicine can learn some lessons from high quality, low cost restaurants like the Cheesecake Factory in order to reduce costs and improve quality.

In the article, Gawande examines ways that the Cheesecake Factory is able to produce consistent, high quality items at a reasonable cost.  Two important ways that this is done is standardization across all menu items, and oversight of each item that is being delivered to customers.  Each item is ranked on a scale of 1-10; any item that is ranked a 6 or below must be remade.  Costs are controlled through minimizing waste; forecasting models are used to predict what items will be ordered, and grocery orders are made based on these forecasts.

Gawande states that standardization and cost control are spilling over into medicine now, and may be the answer to controlling health costs.  Some examples of standardization and oversight currently being used in medicine include:

  • In an orthopedic practice at Brigham and Women’s Hospital, seventy-five percent of knee replacements use a standardized implant.  This has allowed bargaining power for the hospital as they are purchasing more parts, and allows for a lower cost per procedure. 
  • Steward Healthcare System is using ICU telecommunications to provide oversight of its ten ICUs.  The ICU telestaff are able to provide an additional set of eyes for ICU staff, and can monitor lab results, vital signs and make virtual rounds from offsite. 
  • Cleveland Clinic has an arrangement with Lowe’s, guaranteeing a fixed price for cardiac surgery for the company’s employees and dependents, airfare and lodging are paid for.

Gawande concludes that while steps are being taken to control costs and improve quality in medicine, there is much work to be done.

(Sources: The Advisory Board Daily Briefing,, August 7, 2012; The New Yorker,, August 13, 2012)