Last fall, I had a post on Dr. Devi Shetty and his Narayana Hrudayalaya Hospital. This is a facility specializing in heart surgeries by the dozens. The do essentially just on thing but do a lot of it. The resulting efficiencies allow them to turn a profit event though a large fraction of surgeries are done for free. Now the BBC has a report on Dr. Shetty so it seems worth revisiting the story.
I’m not sure I have anything to add over what I posted last fall except for an additional caveat on why this might be hard to implement in the west. I grant that such specialized facilities could greatly reduce the cost of care on these procedures. However, what happens to the hospitals that are currently doing these surgeries? Our country is populated with general purpose hospitals. That may not be ideal but it is the installed infrastructure. Their operations suppose that they do some mix of delivering babies, treating people in the ER, and heart surgeries. If heart surgeries are pulled out, that means the cost structure is out of whack. Simply moving to high volume specialty hospitals without having some transition in place for the current general hospitals would likely imperil those hospitals that communities count on for emergency response.
As the flight to Mexico for some medical services shows, people and enterprises will find ways to use cheaper services. In a few years you may find that your heart surgery benefit from northwestern will include a vacation in Cancun. It’s a war out there for hospitals even now, a competitive nightmare. I think it is just a question of time till an entrepreneur tries to do this here.
I wonder how much of the current hospital job balance results from attempts to avoid the non-paying emergency care business. Our local hospital, which almost went bankrupt a few years ago under management by Tenet, is offering specialty services to attract paying patients (specialty cancer care, birthing center) because it has a very large non-paying clientele and needs to establish a reputation as a center of excellence to get paying consumers to come. It is quasi public, so it cannot just abdicate caring for the local population, as Tenet tried to do.
Since repetition breeds excellence, it is easy to see how a heart surgery factory could become such a profit center.
[...] A heart surgery assembly line « The Operations Room. [...]