Pick Any Two

I read an interesting sign thumbtacked to a wall near a desk in a doctor’s office:

Quick medical care
Free medical care
Quality medical care

Pick any Two

Apparently this is an offshoot of the Engineering Project Triangle, but the analogy applies to medial care just as much as engineering.
Perhaps that’s part of the problem with the great discord in patient care right now – especially in the ED. Everyone wants quick, free, and quality. I don’t think you can get all three in our system.

So which one do we drop?










8 Responses to “Pick Any Two”

  1. Dethl says:

    Personally, I would like it good and cheap. I don’t really want to have a poorly done surgery that would leave me crippled in some way for life, and I doubt anyone wants to pay large amounts of money to be healthy. Speed isn’t exactly that important to me. I wouldn’t schedule anything dreadfully important right after a appointment, and I doubt I would care much about some sort of appointment if I was feeling sick and going into the ED on the spur of the moment. Only if I was stuck in a surgery wait list for months upon months would I be cursing the health care system.

    Also, hi.

  2. Dx:Ddx says:

    The paradigm isn’t that you have to pick only two, but that if you push in one direction, the other two suffer. Fast costs more, good costs more, cheap isn’t good, etc. Actually, the way I have sen this stated( Everett Koop in the 1990’s) was the three, cost, accessibilty(?=fast), quality, and you could only maximize two of the three.
    I agree with the concept of balance. I do not believe the market is a balancing force…

  3. Kat says:

    Simple! Free and quality medical care. Because if the care has quality, then it would be quick; The “free” comes as an asset!

  4. WhiteCoat says:

    Dx is right – we are not talking about absolutes.
    But it is interesting that two people chose free and quality. That system exists in many other countries right now in the form of socialized medicine. People in such systems who can afford to do so are going elsewhere to get their health care faster.

  5. ali says:

    love this-thinking i’ll put it up at work!

  6. Tim Hulsey, MD says:

    Actually, there is a fourth dimension: Total coverage. That’s really all Obama wants to think about. He wants to be able to say that everyone is covered! He really doesn’t give a care about the other three points. As with most things “government,” they just want to be able to say, “We have a program for that.” Whether it works or whether you can actually talk to the government about it is unimportant!

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