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Published at www.nejm.org August 26, 2009 (10.1056/NEJMopv0907607)

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It is a tired and cynical cadre of physicians who will implement health care reforms. Yet few published perspectives include the view from the factory floor. The usual platitudes about changing financial incentives, increasing efficiency, and delivering high-quality care sound naïve to clinicians who deal with the imperfections of human nature and the messy effects of illness on patients. Doctors are already, by training, sophisticated decision-making machines, capable of achieving extreme efficiency through the use of heuristics and experience.

The main problems that clinicians face in achieving efficiency and reducing costs are, first, a perceived need for certainty in diagnosis . . . [Full Text of this Article]

Source Information

Brigham and Women's Hospital
Boston, MA

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