By chance last week I tuned in to a TV newscast as the announcer said, “A study has concluded 30 per cent of MRIs contribute nothing to the treatment of a patient.” I was stunned.
An MRI (or magnetic resonance imaging) is a technique that uses a magnetic field and radio waves to create detailed three-dimensional images of the organs and tissues within your body. The patient lies on a table which then moves forward into an enclosed cavern resembling an oversized laundry dryer. A computer reveals the images to a radiologist who interprets them for the attending physician as a guide to the patient’s treatment.
Besides the substantial cost of the MRI machine itself, each exam involves the time of highly qualified medical staff. Then to learn 30 per cent of the time the “work” this machine and staff are doing is of no benefit to the patient is somewhat startling.
The reasons for ordering an MRI (or other tests) that may contribute little if anything to a patient’s care are many, including to do a complete workup while the patient is in the hospital anyway, to fish around ‘in case’, but chiefly the fear of a malpractice lawsuit.
Our health care system needs the waste control know-how of Henry Ford, the car manufacturer who streamlined his plant and models to maximize every movement a worker made.
Ford studied the successful practices of other industries from factories to meat packing plants and identified four principles that would increase his output and profits: interchangeable parts, continuous flow, division of labour, and reducing wasted effort.
Patients don’t come with interchangeable parts, unless you’re referring to transplants.
Ford produced cars with interchangeable parts so any valve fit any model, any steering wheel fit any car. Instead of each labourer learning and performing all steps to build a car, each worker became skilled in one of the 84 steps in manufacturing a car. With the moving assembly line he instituted, workers stood still while the car chassis and parts came to them.
By installing a moving belt in his factory, employees were able to build cars one piece at a time, instead of one car at a time. This principle, called “division of labour,” allowed workers to focus on doing one task expertly, rather than being responsible for a number of diverse tasks.
Ford’s efficiency so reduced the individual cost of each Model T he was able to drop the price from $850 to $290, making his cars even more affordable to buyers.
Early in 1941 Ford was granted government contracts whereby he was, at first, to manufacture parts for bombers and, later, the entire airplane. Each plane was comprised of 1,225,000 parts, a leap from the Model T’s 1800 parts.
He constructed a separate airplane factory in Willow Run, Michigan on 335 acres near Detroit. The building was so long that the far end of it branched off at 90 degrees to he wouldn’t have to pay taxes in another county. Detractors agog at the plant’s size – at that time the largest under a single roof – called it “Willit Run?”
Here he geared up to produce one complete bomber every 55 minutes, an achievement that borders on incredulity.
Powered by four 1200 HP air cooled engines, the B24 Liberator bomber with a wingspan of 110 feet and a length of 67 feet could carry ten men, four tons of bombs, and fly 3,000 miles nonstop at 300 mph.
By 1945, when the Second World War ended, Ford’s Willit Run plant had manufactured 8,685 bombers.
Ford would promptly rid our health care of useless MRIs.