ASA Deming Lecture by Brent James: Long Term View of the Healthcare System

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Guest post by John Hunter, who founded in 1996.

2010 ASA Deming Lecture – “Dr. Deming Consults on Quality for Sir William Osler” by Brent James, Institute for Health Care Delivery Research. Brent James has worked at Intermountain Healthcare for several decades. I wrote a previous post on this blog about a paper he wrote about using Deming’s ideas at Intermountain Healthcare.

YouTube video

The beginning of the talk provides an overview of the huge macroeconomic risks of the health care system in the USA. As those familiar with Deming’s ideas know, Dr. Deming added excessive health care costs to his 7 deadly diseases of Western management. The last 2 deadly diseases he added specifically about problems in the USA: excessive health care costs and excessive legal damage awards swelled by lawyers working on contingency fees.

Next, Brent James looks at the long term history of health care in the USA and the great gains achieved during the 1900s. On this success Brent says

We routinely achieve miracles, and it is attributable to Osler and his colleagues and the vision that they had for a new world.

As he explained earlier that vision was to learn what was working and what wasn’t by collecting and studying data on patients and experimenting using the scientific method to improve health care results.

The presentation then explores the enormous opportunities for improvement in the current health care system. One of the many very interesting ideas Brent presents is the problem of spreading new medical knowledge to the people working in the healthcare system.

[People] couldn’t keep up. He [researcher] found that 3 to 4 years 14 to 15 years after initial board certification 2/3 of internists couldn’t pass the qualifying exam. Even better work came from John Williamson at Hopkins, Williamson demonstrated that for a major new research finding to make it into widespread practice across the United State takes about 17 to 20 years.

Brent spoke of several process improvements demonstrating Deming’s Chain Reaction (improving processes increases quality and reduces costs).

This is another excellent presentation; I recommend taking the time to watch it.

We have now added blog posts on all ASA Deming lectures from 2009 through 2017, the others are:

2009, J. Stuart Hunter (Princeton University), New Challenges for Statisticians

2011, Roger Hoerl: Need Any Country be Poor?
2012, Dr. Jeff Wu: Quality Improvement from Autos to Nanotechnology
2013, Vijay Nair: Industrial Statistics – Research vs Practice
2014, Sharon Lohr: Red Beads and Profound Knowledge: Deming and Quality of Education
2015, William Meeker: Reliability – Another Dimension of Quality
2016, Vincent Barabba: Profound Knowledge from a Knowledge Use Perspective
2017, Fritz Scheuren: W. Edwards Deming – A Kaizen Statistician

Related: Application of Deming’s System of Profound Knowledge in HealthcareUsing Dr. Deming’s Ideas at Baptist Memorial Health CareThe Importance of Critical Thinking and Challenging Assumptions

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