Streamlining can be beneficial for overwhelmed physician practices.
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This blog was motivated by the book Subtraction by Leidy Klotz, a professor of architecture at the University of Virginia. His book shares that we can enhance what we do by subtracting rather than adding tasks and activities. I am like most physicians, as we are creatures of habit. We keep collecting and adding more to our practice. Still, we need to discard or subtract outdated methods no longer applicable to providing patient care. It took a long time to convert paper charts into electronic medical records. We add new and improved ideas but don't prune the outdated ones. Unfortunately, we are wired to add before taking away. The book provides examples of how subtraction can benefit the practice of medicine.
Two examples of subtraction described in the book are Strider Bikes and H-bricks.
Strider Bikes were created by removing or subtracting the pedals of bikes that are used to train toddlers to ride two-wheel bikes. With a Strider Bike, the child learns balance and can go directly to a pedal bike without the necessity of transitioning to training wheels. Strider Bikes have been used by over 3 million toddlers.
Solid cinder blocks used in construction are heavy, require more material, are difficult to transport, and require more musculoskeletal exertion to use. Subtracting the center of the block or creating an H-block did not impair its strength. The H-block (Figure 2) was not as heavy, made better insulation, was easier to transport, was less expensive, and decreased back pain from workers lifting the heavier solid bricks.
10 Subtraction examples in healthcare
Bottom Line: Every practice has "excess fat" that can be subtracted. Subtracting results in a more efficient practice, increased production, and improved morale. It may decrease the epidemic burnout rate of physicians.
If you have any suggestions for subtracting in your practice, please let me hear from you at doctorwhiz@gmail.com.
Neil Baum is a physician in New Orleans and the author of The Business of Building and Managing a Healthcare Practice, Springer 2023
* Klotz, L. (2021). Subtract: The untapped science of less. Flatiron Books.
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