Cooperating for better care.

News & Views

Reduce the number of medical cooks

Share this:



“A Kitchen Interior” (c. 1565), by Marten van Cleve.

Suneel Dhand, M.D., an internist, ┬ásays medicine is suffering from “Too Many Cooks in the Kitchen Syndrome”.
The scenario goes like this.”A patient is admitted to hospital and due to the complexity of their illness, they will end up seeing a number of different specialists. In the old days, their primary care doctor would still be seeing them in the hospital. Now however, they are typically assigned to an internal medicine doctor, known as a ‘hospitalist.’

“The problem is that this hospitalist usually hasn’t met them before, so has to start from scratch. Depending on the case, other specialists involved in their care may also include surgeons, cardiologists, pulmonologists, nephrologists, gastroenterologists — you name it! But due to the busy environment of a hospital, there will often be very little direct communication between these different doctors.”

This is “emblematic of a much bigger problem — namely, the fragmentation of the healthcare system. It negatively affects patient satisfaction and the hospital experience, causing a lot of frustration and miscommunication along the way.”

“So what’s the solution? Well, the start would be to make it absolutely crystal clear who the “captain of the ship” is during the hospitalization. This will usually be the hospital physician (for a medical patient). The next step is to ensure that every specialist who sees the patient understands who this primary doctor is (and also re-emphasizes that to the patient), and communicates their plan immediately to them.”

“The next thing is to get the hospital physicians on board themselves to take on the mantle of “captain of the ship” — even if care is mainly being directed by another specialist (e.g., a patient awaiting a surgical procedure). Furthermore, these physicians need to have adequate time to take on this role, so it’s critical that they shouldn’t be overwhelmed themselves with excessive workloads.”


Contact Info

(617) 230-4965

Wellesley, Mass