Skip to content
  • About
  • Contact
  • Contribute
  • What Physicians Say
  • My Book
  • Careers
  • Podcast
  • Speaking
KevinMD.com — Social media's leading physician voice
  • All
  • Physician
  • Burnout
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • All
  • Physician
  • Burnout
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
    • All
    • Physician
    • Burnout
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • About
    • Contact
    • Contribute
    • What Physicians Say
    • My Book
    • Careers
    • Podcast
    • Speaking
KevinMD.com — Social media's leading physician voice
  • All
  • Physician
  • Burnout
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
    • All
    • Physician
    • Burnout
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • About
    • Contact
    • Contribute
    • What Physicians Say
    • My Book
    • Careers
    • Podcast
    • Speaking
  • About Kevin Pho, MD, Founder of KevinMD
  • Aging and dementia: what physicians say, in their own words
  • Artificial intelligence: what physicians say, in their own words
  • Be heard on social media’s leading physician voice
  • Cancer: what physicians say, in their own words
  • Children’s health: what pediatricians say, in their own words
  • Contact Kevin
  • COVID-19: what physicians wrote as it happened
  • Custom enhanced author page pricing
  • Diabetes and obesity: what physicians say, in their own words
  • Direct primary care: what physicians say, in their own words
  • DMCA Policy
  • End of life: what physicians say, in their own words
  • Establishing, Managing, and Protecting Your Online Reputation: A Social Media Guide for Physicians and Medical Practices
  • GLP-1 drugs: what physicians say about Ozempic and its successors, in their own words
  • Heart disease: what physicians say, in their own words
  • Immigration and medicine: what physicians say about immigrant doctors and immigrant patients, in their own words
  • KevinMD influencer opportunities
  • Medical errors: what physicians say, in their own words
  • Medical ethics: what physicians say, in their own words
  • Medical malpractice: what physicians say, in their own words
  • Medical school: what students and physicians say, in their own words
  • Mental health: what psychiatrists and physicians say, in their own words
  • Nursing: what nurses and physicians say, in their own words
  • Opinion and commentary by KevinMD
  • Opioids: what physicians and pain patients say, in their own words
  • Physician burnout speakers to keynote your conference
  • Physician burnout: what physicians say, in their own words
  • Physician Coaching by KevinMD
  • Physician keynote speaker: Kevin Pho, MD
  • Physician personal finance: what physicians say about their own money, in their own words
  • Physician Speaking by KevinMD: a boutique speakers bureau
  • Physician suicide: what physicians say, in their own words
  • Physicians and administrators: what physicians say about who runs medicine, in their own words
  • Primary care physician in Nashua, NH | Kevin Pho, MD
  • Primary care: what physicians say, in their own words
  • Prior authorization: what physicians say, in their own words
  • Privacy Policy
  • Private equity and corporate medicine: what physicians say, in their own words
  • Race and medicine: what physicians say, in their own words
  • Recommended services by KevinMD
  • Residency: what residents and attendings say, in their own words
  • Scope of practice: what physicians, nurse practitioners, and PAs say, in their own words
  • Subscribe to the KevinMD enhanced author page
  • Subscribe to the newsletter
  • Surgeons and surgery: what surgeons say, in their own words
  • Take-home messages: what physicians say when asked to leave one
  • Terms of Use Agreement
  • Thank you for subscribing to KevinMD
  • Thank you for upgrading to the KevinMD enhanced author page
  • The electronic health record: what physicians say, in their own words
  • Vaccines: what physicians say, in their own words
  • Violence against health care workers: what physicians and nurses say, in their own words
  • What physicians say: the KevinMD records
  • Women in medicine: what women physicians say, in their own words
  • Women’s health: what physicians say, in their own words

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 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

  • Choosing a limb lengthening surgeon requires accountability

    Hrayr Basmajian, MD
  • How to reassure patients: 5 steps beyond normal tests

    Devina Maya Wadhwa, MD
  • Setting boundaries as a physician doesn’t mean caring less

    Jerina Gani, MD, MPH
  • How emergency medicine decision making works under pressure

    Geoffrey Mount Varner, MD, MPH
  • Why I stay in emergency medicine: a dancer at nearly 100

    Howie Mell, MD, MPH
  • Distrust of science is inviting the Middle Ages back

    Tomi Mitchell, MD
  • Most Popular

  • Past Week

    • Retirement isn’t the end of medicine, it’s a second act [PODCAST]

      The Podcast by KevinMD | Podcast
    • The conflict of interest that discloses as nothing

      Martha Rosenberg | Medications
    • Surgical judgment: the skill no one sees from the gallery

      Mustafa Kemal Çalık, MD | Physician
    • Why haven’t ambient AI scribes boosted productivity?

      Karan Kanwar | Health Technology
    • Physician well-being is not an individual problem

      Heather Buckley | Conditions and Diseases
    • Burnout isn’t only about autonomy, it’s about your bank account [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Why CDC opioid guidelines get the overdose data wrong

      Richard A. Lawhern, PhD | Conditions and Diseases
    • Retirement isn’t the end of medicine, it’s a second act [PODCAST]

      The Podcast by KevinMD | Podcast
    • Sensory processing in autism and the brain’s volume control

      Josette Pelatan, PhD | Conditions and Diseases
    • What maternity care deserts cost a town

      Manisha Kaliaperumal | Health Policy
    • Why medicine needs a national physician license now

      Vaishali Popat, MD, MPH | Physician
    • A cold cost $945. The cost of primary care is broken.

      Susan Newman, MD | Physician
  • Recent Posts

    • Shift work and circadian rhythms shape the 24/7 workplace

      Deepak Gupta, MD | Conditions and Diseases
    • Paid for twice

      Physicians paid for G2211 twice. Most never bill it.

      Michael Duben, MD | Physician Finance
    • The next child

      Medicaid managed care and the case for mutual stewardship

      Steven Merahn, MD | Health Policy
    • Choosing a limb lengthening surgeon requires accountability

      Hrayr Basmajian, MD | Physician
    • Cited but never checked

      Why AI crisis advice may fail families facing psychosis

      Nicole Drapeau Gillen | Health Technology
    • How AI phone systems in health care create barriers

      Thuy D. Bui, MD | Health Technology

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

  • Most Popular

  • Past Week

    • Retirement isn’t the end of medicine, it’s a second act [PODCAST]

      The Podcast by KevinMD | Podcast
    • The conflict of interest that discloses as nothing

      Martha Rosenberg | Medications
    • Surgical judgment: the skill no one sees from the gallery

      Mustafa Kemal Çalık, MD | Physician
    • Why haven’t ambient AI scribes boosted productivity?

      Karan Kanwar | Health Technology
    • Physician well-being is not an individual problem

      Heather Buckley | Conditions and Diseases
    • Burnout isn’t only about autonomy, it’s about your bank account [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Why CDC opioid guidelines get the overdose data wrong

      Richard A. Lawhern, PhD | Conditions and Diseases
    • Retirement isn’t the end of medicine, it’s a second act [PODCAST]

      The Podcast by KevinMD | Podcast
    • Sensory processing in autism and the brain’s volume control

      Josette Pelatan, PhD | Conditions and Diseases
    • What maternity care deserts cost a town

      Manisha Kaliaperumal | Health Policy
    • Why medicine needs a national physician license now

      Vaishali Popat, MD, MPH | Physician
    • A cold cost $945. The cost of primary care is broken.

      Susan Newman, MD | Physician
  • Recent Posts

    • Shift work and circadian rhythms shape the 24/7 workplace

      Deepak Gupta, MD | Conditions and Diseases
    • Paid for twice

      Physicians paid for G2211 twice. Most never bill it.

      Michael Duben, MD | Physician Finance
    • The next child

      Medicaid managed care and the case for mutual stewardship

      Steven Merahn, MD | Health Policy
    • Choosing a limb lengthening surgeon requires accountability

      Hrayr Basmajian, MD | Physician
    • Cited but never checked

      Why AI crisis advice may fail families facing psychosis

      Nicole Drapeau Gillen | Health Technology
    • How AI phone systems in health care create barriers

      Thuy D. Bui, MD | Health Technology

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

  • Terms of Use Agreement
  • 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...