What do the U.S. healthcare delivery system and The Cheesecake Factory have in common?
According to Dr. Atul Gawande, potentially a great deal. The Dr. recently penned an article over at The New Yorker called, “Big Med.” Inspired by his experience at The Cheesecake Factory (TCF), he wondered if perhaps there weren’t some way that the system at The Cheesecake Factory could be used as a pattern for US healthcare delivery. After all, TCF delivers millions of meals in a cost-effective and profitable manner – why couldn’t the healthcare system treat millions of people in a cost-effective and profitable manner?
The Dr. shares that, indeed, there are already some clinicians implementing TCF-esque solutions. While the Dr. doesn’t bring it up, this article over at The Economist, highlights how healthcare delivery is undergoing innovation in India - reflecting in many ways, Dr. Gawande’s TCF inspired vision.
In response, Steve Denning at Forbes, wrote an article entitled: “How Not to Fix US Healthcare: Copy The Cheesecake Factory.” Mr. Denning thought that Dr. Gawande was way off base using The Cheesecake Factory as a pattern. He cited Innovation Scholar, Clayton Christensen, and then claimed that Dr. Gawande’s argument is flawed in these ways:
2.Wrong knowledge model
3.Wrong management model
4.Wrong conclusions about scaling
In actuality the above discussion is both/and vs. either/or. When trying to come up with truly innovative solutions, the goal is to take two or more ideas/metaphors, slam them together, and see what comes out of the mix.
Personally, I think Dr. Gawande’s perspective is highly provocative and has something going for it. His thinking isn’t ‘pie in the sky.’ There is, as the Dr. demonstrates, plenty of room for standardization and better management of spending/costs without sacrificing care. Precisely because the TCF model is, on first blush, so different from the healthcare world and yet similar with regards to servicing millions in a cost-effective, profitable manner, that we will benefit greatly from creating a synthesis between healthcare delivery and what goes on in The Cheesecake Factory.
We should smash the TCF metaphor up against current healthcare practices and see what comes out of it. That’s where great innovation will come from! After all, the Cheesecake Factory IS successful and is doing something right. Many healthcare institutions in India ARE doing something right. The doctors in Dr. Gawande’s article ARE doing something right, saving money and improving outcomes. There’s got to be something we can learn, be inspired by, and perhaps implement and test, when metaphors dance into a tertium quid.
It doesn’t further discussions, and in fact limits solutions, to caricature Dr. Gawande’s insights. Instead of claiming, as Mr. Denning did, that everything is “wrong” with Dr. Gawande’s vision, the discussion would be furthered by full-hearted listening, combining of metaphor, and dreaming of what can be.
I think the discussion would be even better if done over a meal at The Cheesecake Factory.