AHIP: Gawande, Gladwell on Healthcare's Chauffeur Problem

Margaret Dick Tocknell, June 25, 2012

The healthcare industry's unwillingness to let go of the so-called "chauffeur model" has prevented commodification and customer autonomy from developing in healthcare delivery, according to Malcolm Gladwell, the noted New Yorker writer and book author.

"That person who stands between the consumer and a (medical) service or technology, and serves as a powerful intermediary, remains in place in healthcare" today just as that person did at the beginning of the healthcare industry, Gladwell asserted Friday at the 2012 conference for America's Health Insurance Plans.

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Not so, countered Harvard professor and author Atul Gawande, MD, who joined Gladwell on stage. "The real problem with the healthcare industry is that it focuses on having great components. We're obsessed with components. We want the best drugs, best tools, and best specialists, but we spend very little time thinking about how everything will work together."

He likened the obsession with the best components to building a car with Porsche brakes, a Ferrari engine, a Volvo body, and a BMW chassis. "Put it all together and what you have is an expensive pile of junk that doesn't go anywhere because the pieces don't work together."

Margaret Dick Tocknell Margaret Dick Tocknell is a reporter/editor with HealthLeaders Media.


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