The Price of Efficiency

Soon after my residency training in heart surgery, I worked at a corporate hospital for a few months. It was an efficient, streamlined unit. Surgeons spent most of their time inside the operating room. Different specialists managed specific parts of the patient care process.

But no one was involved in every part. And team members took pride in statistics like the total number of patients operated, low complication rates, and effective resource utilization.

It was impersonal.

When I returned after a fellowship in U.K. and Australia, I spent a year at another corporate hospital. The interaction with patients was slightly more for doctors, though not much.

Primarily, we performed operations, and responsibility for other areas was very limited. While some satisfaction for specific patient outcomes was felt, team members by and large rejoiced in numbers and data rather than people.

It was abstract.

Now, I head and manage my own program. It isn’t very large. I am directly engaged in every step of the process – whether it involves patients or not. There are days I feel more like purchase manager or HR executive than surgeon!

I am also responsible for anything that goes wrong or doesn’t work or is missing when it’s needed. Engagement with patients and their families is personal, direct and frequent. It can happen at inconvenient times during the day (or night, too).

It is intensely personal.

Today, as I waved goodbye to my little 6-year old patient who has recovered from a complex congenital heart defect repair and is going back home, I felt a thrill of sheer delight as he smilingly waved back, and a grin lit up his tiny shining face.

It felt special… because I’m involved in every part of his treatment.

Efficiency comes at a price.

But, so does inefficiency!

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1 Comment
  • Dec 29,2009 at 11:54 am

    Dr. Mani, end-of-the-year greetings from a snow-clad Mount Fuji in Japan. Your words intensely personally and direct underscore the significance of real engagement in the here and now of your life. Efficiency too often implies the fastest, straightest line towards a narrowly defined goal. But the well-lived life rarely unfolds in a straight line. All the time we spend in the ups and downs, the side roads, and the turns and twists is what ultimately teaches us the meaning of who we are and what we are doing here. Inefficiency helps bring us to the heart of our existence as human beings in the web of life. Thank you for your post. And best wishes for bringing in the New Year!

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