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To the Editor: In his Commentary on efficiency in the health care industries, Dr Grove¹ provides an outside view, offering a business analogy that fails to consider that medical care is a repair service, not a manufacturing operation. Manufacturers prosper by carefully choosing their materials, procedures, and products. Medical care is stuck with faulty carbon-based people who walk in the door to receive US Food and Drug Administration–approved treatments. With his analogy, the questions to consider are how profitable Intel could have been if its core business was repairing failed Motorola chips, and how much more profitable a medical facility could become if it eliminated patients who, before they became ill, were drug abusers, alcoholics, smokers, or obese.

Business experts do not tout profit in repair. They build enough good units to afford burying their mistakes. Many microchips fail, not fall, off the assembly line. Cell phones are replaced, . . . [Full Text of this Article]

Seth Powsner, MD
seth.powsner@yale.edu
Department of Psychiatry
Yale University
New Haven, Conn

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Efficiency in the Health Care Industries: A View From the Outside
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