Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
KevinMD
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking
KevinMD
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking
  • About KevinMD | Kevin Pho, MD
  • Be heard on social media’s leading physician voice
  • Contact Kevin
  • Discounted enhanced author page
  • DMCA Policy
  • Establishing, Managing, and Protecting Your Online Reputation: A Social Media Guide for Physicians and Medical Practices
  • Group vs. individual disability insurance for doctors: pros and cons
  • KevinMD influencer opportunities
  • Opinion and commentary by KevinMD
  • Physician burnout speakers to keynote your conference
  • Physician Coaching by KevinMD
  • Physician keynote speaker: Kevin Pho, MD
  • Physician Speaking by KevinMD: a boutique speakers bureau
  • Primary care physician in Nashua, NH | Doctor accepting new patients
  • Privacy Policy
  • Recommended services by KevinMD
  • Terms of Use Agreement
  • Thank you for subscribing to KevinMD
  • Thank you for upgrading to the KevinMD enhanced author page
  • The biggest mistake doctors make when purchasing disability insurance
  • The doctor’s guide to disability insurance: short-term vs. long-term
  • The KevinMD ToolKit
  • Upgrade to the KevinMD enhanced author page
  • Why own-occupation disability insurance is a must for doctors

There are too many cooks in the health care kitchen

Suneel Dhand, MD
Physician
October 28, 2015
Share
Tweet
Share

shutterstock_61638394

There’s a new epidemic sweeping American hospitals, and a cure is desperately needed. It’s highly contagious and causes the sufferer much anxiety and psychological suffering. It also costs the health care system millions, if not billions, of dollars a year. You may never have heard of it. You won’t find it in the medical textbooks nor will you hear any of the great teachers of medicine talking about it. It has a strange name: Too Many Cooks in the Kitchen Syndrome.

OK, it’s not actually a medical illness and doesn’t have its roots in the biology of the human body. But it can still be very disabling and disruptive to the individual, and importantly affects hundreds of thousands of hospitalized patients each year. Ask any frontline doctor and they will see it in action each day on the medical floors.

The scenario goes something 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.

For instance, it’s a highly common occurrence for one specialist to tell the patient one thing (e.g., “Your heart is definitely the problem”) and another specialist an hour later to say something completely different (“Your lungs are definitely the main problem”). In between, the hospitalist wouldn’t necessarily be getting regular updates on what’s being done, what new medications are being given, and how the treatment strategy may have changed. All this while the patient is being overwhelmed with information from so many different physicians!

The above situation plays out all across the country every day and is actually emblematic of a much bigger problem — namely, the fragmentation of the health care 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. This doesn’t have to be a lengthy process, and could be as simple as a “text page.”

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.

Patients need to know who their main doctor is in the hospital — the main port of call — in order to feel comfortable and always have a go-to person. While many physicians may be involved in getting them better, there can only ever be one clear chief. That’s the way to avoid Too Many Cooks in the Kitchen Syndrome.

Suneel Dhand is an internal medicine physician and author of Thomas Jefferson: Lessons from a Secret Buddha and High Percentage Wellness Steps: Natural, Proven, Everyday Steps to Improve Your Health & Well-being. He blogs at his self-titled site, Suneel Dhand.

Image credit: Shutterstock.com

Prev

Maybe it's time to stop the thinking and just be

October 27, 2015 Kevin 0
…
Next

Bad data vs. no data: Defending ProPublica

October 28, 2015 Kevin 0
…

ADVERTISEMENT

Tagged as: Hospital-Based Medicine

< Previous Post
Maybe it's time to stop the thinking and just be
Next Post >
Bad data vs. no data: Defending ProPublica

ADVERTISEMENT

More by Suneel Dhand, MD

  • The dream patient that makes a doctor very happy

    Suneel Dhand, MD
  • When the family wants to speak to the doctor

    Suneel Dhand, MD
  • 3 reasons why patients are unhappy

    Suneel Dhand, MD

Related Posts

  • How social media can help or hurt your health care career

    Health eCareers
  • Why health care replaced physician care

    Michael Weiss, MD
  • Turn physicians into powerful health care influencers

    Kevin Pho, MD
  • Health care needs more physician CEOs

    Alexi Nazem, MD
  • Are hospital CEOs responding to the realities of health care?

    Ammura Hernandez, MD
  • Health care is not a service commodity

    Peter Spence, MD, MBA

More in Physician

  • In the age of AI, what makes a physician REAL?

    Harvey Castro, MD, MBA
  • The cost of clinician absence in the boardroom: a 30-year perspective

    Christopher Mastino, MD
  • My wife wants me to retire

    Sandy Brown, MD
  • 2026 Winter Olympics rumors: the truth about ski jumpers and hyaluronic acid

    Arthur Lazarus, MD, MBA
  • From Williams-Sonoma to medicine: What retail taught me about difficult patients

    Jason Wilt, MD
  • Physician wellness theater: Why pizza parties do not fix burnout

    Patrick Hudson, MD
  • Most Popular

  • Past Week

    • Why Medicare must cover atrial fibrillation screening to prevent strokes

      Radhesh K. Gupta | Conditions
    • Why medical school DEI mission statements matter for future physicians

      Aditi Mahajan, MEd, Laura Malmut, MD, MEd, Jared Stowers, MD, and Khaleel Atkinson | Education
    • The American Board of Internal Medicine maintenance of certification lawsuit: What physicians need to know

      Brian Hudes, MD | Physician
    • Teaching joy transforms the future of medical practice [PODCAST]

      The Podcast by KevinMD | Podcast
    • The specter of death: Why mortality gives life meaning

      Steve Sobel, MD | Conditions
    • The health insurance crisis 2026: What Kentuckians need to know

      Susan G. Bornstein, MD, MPH | Policy
  • Past 6 Months

    • Will AI replace primary care physicians?

      P. Dileep Kumar, MD, MBA | Tech
    • What is the minority tax in medicine?

      Tharini Nagarkar and Maranda C. Ward, EdD, MPH | Education
    • Why the U.S. health care system is failing patients and physicians

      John C. Hagan III, MD | Policy
    • Alex Pretti: a physician’s open letter defending his legacy

      Mousson Berrouet, DO | Physician
    • Health care as a human right vs. commodity: Resolving the paradox

      Timothy Lesaca, MD | Physician
    • Why voicemail in outpatient care is failing patients and staff

      Dan Ouellet | Tech
  • Recent Posts

    • The specter of death: Why mortality gives life meaning

      Steve Sobel, MD | Conditions
    • Systemic strain creates the perfect environment for medical gaslighting [PODCAST]

      The Podcast by KevinMD | Podcast
    • In the age of AI, what makes a physician REAL?

      Harvey Castro, MD, MBA | Physician
    • The cost of clinician absence in the boardroom: a 30-year perspective

      Christopher Mastino, MD | Physician
    • My wife wants me to retire

      Sandy Brown, MD | Physician
    • 2026 Winter Olympics rumors: the truth about ski jumpers and hyaluronic acid

      Arthur Lazarus, MD, MBA | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 24 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Why Medicare must cover atrial fibrillation screening to prevent strokes

      Radhesh K. Gupta | Conditions
    • Why medical school DEI mission statements matter for future physicians

      Aditi Mahajan, MEd, Laura Malmut, MD, MEd, Jared Stowers, MD, and Khaleel Atkinson | Education
    • The American Board of Internal Medicine maintenance of certification lawsuit: What physicians need to know

      Brian Hudes, MD | Physician
    • Teaching joy transforms the future of medical practice [PODCAST]

      The Podcast by KevinMD | Podcast
    • The specter of death: Why mortality gives life meaning

      Steve Sobel, MD | Conditions
    • The health insurance crisis 2026: What Kentuckians need to know

      Susan G. Bornstein, MD, MPH | Policy
  • Past 6 Months

    • Will AI replace primary care physicians?

      P. Dileep Kumar, MD, MBA | Tech
    • What is the minority tax in medicine?

      Tharini Nagarkar and Maranda C. Ward, EdD, MPH | Education
    • Why the U.S. health care system is failing patients and physicians

      John C. Hagan III, MD | Policy
    • Alex Pretti: a physician’s open letter defending his legacy

      Mousson Berrouet, DO | Physician
    • Health care as a human right vs. commodity: Resolving the paradox

      Timothy Lesaca, MD | Physician
    • Why voicemail in outpatient care is failing patients and staff

      Dan Ouellet | Tech
  • Recent Posts

    • The specter of death: Why mortality gives life meaning

      Steve Sobel, MD | Conditions
    • Systemic strain creates the perfect environment for medical gaslighting [PODCAST]

      The Podcast by KevinMD | Podcast
    • In the age of AI, what makes a physician REAL?

      Harvey Castro, MD, MBA | Physician
    • The cost of clinician absence in the boardroom: a 30-year perspective

      Christopher Mastino, MD | Physician
    • My wife wants me to retire

      Sandy Brown, MD | Physician
    • 2026 Winter Olympics rumors: the truth about ski jumpers and hyaluronic acid

      Arthur Lazarus, MD, MBA | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today

Copyright © 2026 KevinMD.com | Powered by Astra WordPress Theme

  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

There are too many cooks in the health care kitchen
24 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...