Patients have not comprehended their position in the managed care system as industrial products with no specialized problems. Dr Caroline Poplin, an internist and graduate of the Yale Law School points out that managed care is the industrialization of medicine. In her article “Transaction Social Science and Modern Society” she develops the premise that managed care is pushing medicine toward a more conventional industrial organization. Most manufacturers prosper by breaking down production into standardized tasks requiring little judgment, tasks that could be performed quickly and reliably by workers with relatively low skills. Managed care is such an organization with owners, administrators, and laborers. But who are the laborers? The answer is doctors. Then who are the patients? They are the products. Many patients still remember going to doctors who were the owners, administrators, and laborers in their individual practices. This was good for the patient since he was treated as an individual with this highest of skills tailored for him.
Retail medicine organized as a mechanized industry necessarily means that the product, which are sick human beings, can be treated on an assembly line basis as inanimate widgets.
However, in industry, any product that varies from the norm is discarded. As human beings we all vary from the norm. We can not be discarded. Is this variability that will eventually destroy managed care–unless it comes to a boil so slowly that we humans don’t realize we are dying.