AHIP: Gawande, Gladwell on Healthcare's Chauffeur Problem
Gladwell presented the chauffeur analogy as an example of what happens when new technology is introduced. At first everyone is unfamiliar with the technology and needs a guide. When automobiles were first introduced they were embraced by the wealthy, but because they didn't know how to drive they hired chauffeurs.
Families needed the chauffeur to bridge the technology. Chauffeurs had power; families couldn't travel in the car without them. But, over time as more people became familiar with cars and learned to drive, chauffeurs lost their power.
HealthLeaders Media Breakthroughs
The Promise of Healthcare Analytics
Healthcare is rich in data. Yet healthcare lags in using data analytics to learn about the people it serves and to improve its operations and bottom line. Leaders are overcoming structural and cultural hurdles to involve many end users—executives, managers, and clinicians—as well as analysts.
Gladwell pointed to phototcopying as an industry that let go of its chauffeur and grew by leaps and bounds. He explained that when Xerox first introduced its machines in the 1960s a Xerox rep would be on site to take care of the machine. Offices paid a royalty for the number of copies used. "Xerox was the chauffeur." As other companies entered the business and competition increased, the industry changed. The chauffeur became less important.
He noted that two processes that have happened quickly in other industries, commodification and customer control or consumerization, have been slow in coming to healthcare. The reason, said Gladwell, is the healthcare industry has been unable to compromise on the quality continuum.
"A key step in any kind of technological transition is the acceptance of a temporary deficit in performance at the beginning in exchange for something else," said Gladwell. That something else can eventually include increased convenience and lower cost. He offered a number of examples, including the shift to digital cameras where early pictures were not as good as film and the advent of the digital compression of music, which he contends has made the quality of music worse.
- How Top-Ranked MA Plans Earn Their Stars
- Readmissions: No Quick Fix to Costly Hospital Challenge
- How Hospitals Can Become 'Upstreamists'
- 4 Ways to Lower the Cost to Collect from Self-Pay Patients
- House Calls Key to Pioneer ACO Success
- How Telehealth Pays Off for Providers, Patients
- 4 Tips for Managing Employed Physicians
- Defensive Medicine Still Prevalent Despite Tort Reform
- WellPoint Dominates Nearly Half of Markets, AMA Says
- 'Overtreatment' Debate Circles Back to Lung Cancer Screening