Supply of Medical Services

Are “Focused Factories” a good idea?

In recent years, there has a been a trend towards patient-centered care focusing on caring for a patient holistically.  For instance, a NEJM perspective piece by Porter states:

Accountability for value should be shared among the providers involved. Thus, rather than “focused factories” concentrating on narrow groups of interventions, we need integrated practice units that are accountable for the total care for a medical condition and its complications.

Clearly, integrated care has benefits, particularly for geriatric patients with multiple chronic conditions. If providers do not talk to one another, a medication to confront on of the patient’s illnesses may exacerbate the others.

However, “focused factories” do have their merit. Economists generally believe that increased specialization leads to improved outcomes.  For instance, patients would not want a primary care doctor treating their lung cancer. There clearly is also a benefit in physician and provider specialization.

A key issue in the supply of health care services to patients going forward will be to balance the need for viewing patient’s health status in a holistic fashion while allowing for provider specialize in treating specific ailments.

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