Good Enough Medicine --> mp3 effect --> The Good Enough Revolution: When Cheap and Simple Is Just Fine

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This is probably a stretch - and the article doesn't specifically talk about primary care or low-overhead practices, per se, but...http://www.wired.com/gadgets/miscellaneous/magazine/17-09/ff_goodenough

http://www.wired.com/gadgets/miscellaneous/magazine/17-09/ff_goodenough?currentPage=allWIRED MAGAZINE: 17.09

Gadgets  :  Miscellaneous   RSSThe Good Enough Revolution: When Cheap and Simple Is Just FineBy Capps Email 08.24.09 =============================The article makes the argument that consumers want 3 things...

     ...ease of use     ...continuous availability     ...low priceIs it simple to get what we want out of the technology? Is it available everywhere, all the time—or as close to that ideal as possible?

And is it so cheap that we don't have to think about price? Products that benefit from the MP3 effect capitalize on one or more of these qualities. And they'll happily sacrifice power and features to do so.

------------------------Reminds me of the ol' sign mentioned in past posts.

Anyway, it does go on to talk about Kaiser and how they build a big hospital and have the pharmacy, labs, xray, etc all right there -- basically hi-fidelity medicine.But they were wondering if " Good Enough " would also work -- just give great access to 80% of the care someone needs at a low price and great access (low overhead and small office model anyone?).

It's a little humorous that Kaiser considers the clinic described below a " micro-clinic " -- whereas many of us consider it our daily workplace -- just your average medical office.  :-)==========================

Here are some snippets from the article...In the case of health care, the Good Enough mindset can be seen in a

new initiative by Kaiser Permanente. The largest not-for-profit medical

organization in the country, Kaiser has long relied on a simple

strategy of building complete, self-sustaining hospitals—employing 50

doctors or more—in each region it serves. " It's an efficient model, "

says Michele Flanagin, Kaiser's vice president of delivery systems

strategy. " It offers one-stop shopping: pharmacy and radiology and

everything you want from health care in one building. " But that

approach forces patients who don't live near a hospital to drive a long

way for even the most routine doctor's appointment.

....

In 2007, Flanagin and her colleagues wondered what would happen if,

instead of building a hospital in a new area, Kaiser just leased space

in a strip mall, set up a high tech office, and hired two doctors to

staff it. Thanks to the digitization of records, patients could go to

this " microclinic " for most of their needs and seamlessly transition to

a hospital farther away when necessary. So Flanagin and her team began

a series of trials to see what such an office could do. They cut

everything they could out of the clinics: no pharmacy, no radiology.

They even explored cutting the receptionist in favor of an ATM-like

kiosk where patients would check in with their Kaiser card.

What they found is that the system performed very well. Two doctors

working out of a microclinic could meet 80 percent of a typical

patient's needs. ...

If that 80 percent number rings a bell, it's because of the famous

Pareto principle, also known as the 80/20 rule. And it happens to be a

recurring theme in Good Enough products. You can think of it this way:

20 percent of the effort, features, or investment often delivers 80

percent of the value to consumers. That means you can drastically

simplify a product or service in order to make it more accessible and

still keep 80 percent of what users want—making it Good Enough—which is

exactly what Kaiser did.

Flanagin believes these clinics will enable Kaiser to add thousands

of new members. And they'll do it for less. The per-member cost at a

microclinic is roughly half that of a full Kaiser hospital. The first

microclinic is set to open in Hawaii early next year. Medical care is

now poised for its own manifestation of the MP3 effect.============================Anyway, I thought the article was thought provoking.I can see where a patient may want medical care that includes

     ...ease of use - able to access the doctor - email, cell, etc     ...continuous availability - easily accessible (same day appointments)     ...low price - priced such that an office visit doesn't wipe out their pocketbook for the month

In the past, we've said -- Quality Care, Access to Care, Low Prices -- Pick 2.Maybe we will have to rethink that motto - perhaps the future of Good Enough Medicine is getting all 3.BTW, I don't look on Good Enough Medicine as a put-down -- if anything, it's what primary care has always done -- you know your doctor, s/he is always available, and at a more reasonable price than the ER, specialist, etc.

Locke, MD