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January 2016

The McDonaldization of Medicine

Author Affiliations
  • 1Department of Neurology, University of Rochester Medical Center, Rochester, New York
  • 2Department of Sociology, University of Maryland, College Park
JAMA Neurol. 2016;73(1):15-16. doi:10.1001/jamaneurol.2015.3449

As put forth in The McDonaldization of Society, “the principles of the fast-food restaurant are coming to dominate more and more sectors of American society,”1 including medicine (Table). While designed to produce a rational system, the 4 basic principles of McDonaldization—efficiency, calculability, predictability, and control—often lead to adverse consequences. Without measures to counter McDonaldization, medicine’s most cherished and defining values including care for the individual and meaningful patient-physician relationships will be threatened.

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    1 Comment for this article
    I am a better doctor
    Giovanni B Frisoni | Geneva University Hospitals
    The arguments are touching and the close is a zenith: \"number of lives touched, minds stimulated, and hearts moved\". In my first professional life I have met too many doctors who scorned protocols, guidelines, scales, questionnaires, checklists, templates... in the name of their empathy with patients, but ignored modern nosography, basic pharmacology, and fundamentals of rehabilitation.

    The Macdonaldisation of medicine protects patients from well meaning but ignorant doctors who believe they are better doctors only thanks to empathy. Mindfulness of resources and use of protocols, guidelines, scales... lets you cure many more patients and touch many more lives than in
    unregulated environment. If by chance you also have have a genuine interest in your patients as persons you will also stimulate many more minds, and move many more hearts.