Can MOC and MOL Coexist with Lean Management Approach in Health Care?

I was reading an article the other day entitled “Cardiac treatment improves after taking page from Toyota” about lean management principles in the April 22, 2013 issue of American Medical News. The writer mentioned Dr. John Toussaint’s name. The upshot of the story is that implementing lean management principles led to significant improvements on almost all metrics of heart attack care. When primary care adopted the same approach, improvements in care and patient satisfaction saw similar effects (see link for the full story,

That reminded me of Dr. Toussaint’s presentation in July of 2008, “Quality in Health Care is an Oxymoron. How Do We As Health Care Professionals Change That (Toussaint Presentation as Part of Lecture Series)?” He’s an alumnus of The University of Iowa, John Toussaint, M.D. Dr. Toussaint is president and CEO of ThedaCare Center for HealthCare Value. His talk was inspiring for me, because at the time, I was scouting other employment opportunities after having been at The University of Iowa since 1996 (punctuated by a short stop in private practice).

So I interviewed in Appleton, Wisconsin. I ended up choosing to go elsewhere, which obviously didn’t last long. But I’ll always remember when the negotiating was drawing to a close, I got a phone call from Dr. Toussaint, encouraging me to come to Appleton. I was pretty impressed because he never interviewed me while I was there, had never met me, yet took the time to call my office. I still sometimes wonder what might have happened had I zigged instead of zagged.

ThedaCare’s web site lists the important leaders along with their contact information, including Dr. Toussaint’s email address (Who We Are – Center for Healthcare Value). I thought about sending him a message, once again thanking him and also intending to ask him what he thinks about Maintenance of Certification (MOC) and Maintenance of Licensure (MOL). There’s a MOL implementation pilot project underway right now in Wisconsin. By now, I shouldn’t have to tell my regular readers what I and thousands of other physicians think of these processes which are, in my opinion, burdensome and wasteful.

I thought a good while about contacting him and pretty much gave up on it. He’s a CEO and he probably gets hundreds of emails every day. I liked the idea of ease of access to major movers and shakers in the health care policy making arena–but I doubted he would ever have time to reply.

So of course, I hit the send button.

See Dr. Toussaint’s reply: Dr. John Toussaint’s Reply – The Practical Psychosomaticist

“…And we must build a culture of humanistic clinical excellence.”—Jamos the Elder

“…And we must build a culture of humanistic clinical excellence.”—Jamos the Elder

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