Careful, kind care is our compass out of the pandemic fog

Healthcare has become industrialised. Healthcare organisations have largely responded to rising demand, increased harm, and growing costs by applying management and improvement approaches from manufacturing and engineering to healthcare delivery.1 In the process, they sought and achieved much needed standardisation, reliability, and efficiency. For example, the Aravind eye care system has optimised flow and efficiency, leading to high quality and lower cost cataract surgery for millions of people in India.2Relentlessly pursued, however, industrialised healthcare turns patients into widgets and clinicians into production line workers, the work of caring reduced to processing people through the system. Industrial healthcare has exhausted care givers and patients,3 and morally injured, burned out, and spent clinicians,4 making it humanly unsustainable.Too often, industrialised healthcare hurriedly “processes” patients, each patient indistinguishable from the next, at the expense of preserving continuity of relationships. Clinicians work under the illusion of knowing patients because they have looked at their electronic…
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