To the Editor: In his Commentary on reducing waste, Dr Bush1 has adapted the methods of the Toyota Global Production System to construct a thoughtful analysis of health care resources. Applying a “manufacturing model” to hospital-based services, he proposes remedies to the generation of waste, defined here as the misallocation of time and product. However, among the 7 categories of waste, absent is any mention of its more common definition: the generation of disposable materials. The “waste of stock on hand” alludes to materials excess,1 but only as a miscalculation of required inventory, implying that every product purchased will be used. Persons watching unused products hit the trash bin as expiration dates lapse recognize the difficulty in maintaining a tight alignment between purchases and use.
There are several problems with the type of analysis put forward by Bush. By omitting discussion of medical product disposal, physicians are relieved from addressing a problem that is more visible than those described. It de-emphasizes the basic tenets of modern materials management: maximize reusables, minimize disposables, and implement concerted recycling efforts.2
Medical waste has received little attention in clinical literature, although concerns among scientists3 are increasing. Physicians do have the responsibility to act in their medical microsystems and macrosytems.1 The health care system generates a considerable volume of waste products annually, and while corrective measures have concentrated on toxic pollutants, the 1.8 billion pounds of waste paper emanating from medical facilities each year4 can hardly be ignored.
The consequences of inaction may be dire. Maintaining a restricted definition of waste in US health care systems1 may impede implementing preparatory measures. The automotive5 and other industries have moved beyond the framework referred to in the Commentary by Bush; the health care industry and its professionals should rapidly follow.
Financial Disclosures: None reported.
Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature
Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal
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