"Acquiring clinical knowledge does not qualify you to provide better care," he says. "It's an essential but insufficient feature."
At this point, Banner is in the process of analyzing cost, processes, and clinical processes. "Do we have length-of-stay or cost variation that allows us to determine our complication rate? Our mortality, our morbidity? If there's high variation we want to go after that."
Banner is working hard on standardizing colon surgery now because it has identified that high levels of variation exist between hospitals and even individual surgeons in the system.
"This is not a fast process, it will take several months to assess data, make recommendations, and get to design for implementation," Hensing says.
So I think I'm correct in making the statement that physicians don't respect authority. In the past, as a group, they resisted being told how to better practice their craft not only by administrators without the MD title, but they also resisted those who did have it.
The assumption was that these authority figures could no longer be trusted because they'd gone to the "other side." That is (or was) that the physician in the leadership spot was representing the hospital's best interests on standardization of practice or medical implants or devices, because it favored the hospital's business activities, not necessarily because it had anything to do with improving patient care.
In many cases, as Hensing and his colleagues show, we've come a long way.