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Post: The article about “Medical Taylorism” brings up a lot of valid concerns about how performance indicators and process management improvements do not always result in positive change. Taylorism and Lean six sigma are process improvement methodologies when executed correctly have many benefits to efficiency when applied to the right environment. Taylorism and Lean process have no place in medicine because faster is not always better. In medicine, certain things require time to get it right. Just as the article was hinting to a physician and patient relationship takes time to develop and time to be great. If a physician is rushed in return rushes the patient, they will not able to build strong communication which is required for optimal patient care.[1] The result will be lower patient satisfactory scores and possible a decline in health. An example of how the Lean process had a negative effect was during implementation at two emergency departments in Canada. Nurses and physicians described the results of the process improvement poorly. They said the reconfigured EDs disrupted their established practice routines and resulted in the intensification of their work.[2]
Another reason why Taylorism fails is the feeling of unnecessary pressure it puts upon the employees. Historian Hugh Aitken describes the first work rebellion against Taylorism in the 1900s. Molders went on strike and walked out because they resented being watched and timed by strangers as they worked. Taylorism was then studied and under scrutiny by a special committee formed by the government. They concluded that Taylorism has a dehumanizing effect on workers. When things need to be so exact and autonomous it removes the ability for innovation and growth. [3]
Taylorism and Lean process do have their place in making things better. Certain tasks can be standardized and made more efficient when it is analyzed systematically and analytically. Tasks that we do day in and day out without thinking can always be improved to be better and faster once we realize the amount of waste we are contributing.
[1] Hartzband, P., & Groopman, J. (2016). Medical Taylorism, Lean, and Toyota. New England Journal of Medicine, 374(2), 106–108. doi: 10.1056/nejmc1602596
[2] Zibrowski, E., Shepherd, L., Sedig, K., Booth, R., & Gibson, C. (2018). Easier and Faster Is Not Always Better: Grounded Theory of the Impact of Large-Scale System Transformation on the Clinical Work of Emergency Medicine Nurses and Physicians. JMIR human factors, 5(4), e11013. doi:10.2196/11013
[3] Landry, J. T. (2012, November 16). HBR Lives Where Taylorism Died. Retrieved February 12, 2020, from https://hbr.org/2012/11/hbr-lives-where-taylorism-died
