Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • 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

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

Post navigation

< 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

  • When cancer costs too much: Why financial toxicity deserves a place in clinical conversations

    Yousuf Zafar, MD
  • The hidden rewards of a primary care career

    Jerina Gani, MD, MPH
  • Why doctors regret specialty choices in their 30s

    Jeremiah J. Whittington, MD
  • 10 hard truths about practicing medicine they don’t teach in school

    Steven Goldsmith, MD
  • How I learned to love my unique name as a doctor

    Zoran Naumovski, MD
  • What Beauty and the Beast taught me about risk

    Jayson Greenberg, MD
  • Most Popular

  • Past Week

    • The human case for preserving the nipple after mastectomy

      Thomas Amburn, MD | Conditions
    • Nuclear verdicts and rising costs: How inflation is reshaping medical malpractice claims

      Robert E. White, Jr. & The Doctors Company | Policy
    • IMGs are the future of U.S. primary care

      Adam Brandon Bondoc, MD | Physician
    • Why I left the clinic to lead health care from the inside

      Vandana Maurya, MHA | Conditions
    • How doctors can think like CEOs [PODCAST]

      The Podcast by KevinMD | Podcast
    • A surgeon’s testimony, probation, and resignation from a professional society

      Stephen M. Cohen, MD, MBA | Physician
  • Past 6 Months

    • Health equity in Inland Southern California requires urgent action

      Vishruth Nagam | Policy
    • How restrictive opioid policies worsen the crisis

      Kayvan Haddadan, MD | Physician
    • Why primary care needs better dermatology training

      Alex Siauw | Conditions
    • Why pain doctors face unfair scrutiny and harsh penalties in California

      Kayvan Haddadan, MD | Physician
    • How a doctor defied a hurricane to save a life

      Dharam Persaud-Sharma, MD, PhD | Physician
    • What street medicine taught me about healing

      Alina Kang | Education
  • Recent Posts

    • Affordable postpartum hemorrhage solutions every OB/GYN can use worldwide [PODCAST]

      The Podcast by KevinMD | Podcast
    • When cancer costs too much: Why financial toxicity deserves a place in clinical conversations

      Yousuf Zafar, MD | Physician
    • Psychiatrist tests ketogenic diet for mental health benefits

      Zane Kaleem, MD | Conditions
    • The hidden rewards of a primary care career

      Jerina Gani, MD, MPH | Physician
    • Why physicians should not be their own financial planner

      Michelle Neiswender, CFP | Finance
    • Why doctors regret specialty choices in their 30s

      Jeremiah J. Whittington, MD | 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

    • The human case for preserving the nipple after mastectomy

      Thomas Amburn, MD | Conditions
    • Nuclear verdicts and rising costs: How inflation is reshaping medical malpractice claims

      Robert E. White, Jr. & The Doctors Company | Policy
    • IMGs are the future of U.S. primary care

      Adam Brandon Bondoc, MD | Physician
    • Why I left the clinic to lead health care from the inside

      Vandana Maurya, MHA | Conditions
    • How doctors can think like CEOs [PODCAST]

      The Podcast by KevinMD | Podcast
    • A surgeon’s testimony, probation, and resignation from a professional society

      Stephen M. Cohen, MD, MBA | Physician
  • Past 6 Months

    • Health equity in Inland Southern California requires urgent action

      Vishruth Nagam | Policy
    • How restrictive opioid policies worsen the crisis

      Kayvan Haddadan, MD | Physician
    • Why primary care needs better dermatology training

      Alex Siauw | Conditions
    • Why pain doctors face unfair scrutiny and harsh penalties in California

      Kayvan Haddadan, MD | Physician
    • How a doctor defied a hurricane to save a life

      Dharam Persaud-Sharma, MD, PhD | Physician
    • What street medicine taught me about healing

      Alina Kang | Education
  • Recent Posts

    • Affordable postpartum hemorrhage solutions every OB/GYN can use worldwide [PODCAST]

      The Podcast by KevinMD | Podcast
    • When cancer costs too much: Why financial toxicity deserves a place in clinical conversations

      Yousuf Zafar, MD | Physician
    • Psychiatrist tests ketogenic diet for mental health benefits

      Zane Kaleem, MD | Conditions
    • The hidden rewards of a primary care career

      Jerina Gani, MD, MPH | Physician
    • Why physicians should not be their own financial planner

      Michelle Neiswender, CFP | Finance
    • Why doctors regret specialty choices in their 30s

      Jeremiah J. Whittington, MD | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today
  • 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...