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Making cars and making health care: a critical review

Sarah Winch and Amanda J Henderson
Med J Aust 2010; 192 (5): . || doi: 10.5694/j.1326-5377.2010.tb03522.x
Published online: 1 March 2010

To the Editor: It is pleasing to see the acknowledgement by contributors of the fundamental premise that the fragmentation of health care may reduce the quality provided, which was a key argument of our article.1 Our aim was to provide space for critical appraisal of “lean thinking” and its application to health care, by questioning the assumed theoretical basis from which this approach is derived and enquiring about the evidence for long-term benefits relating to patient outcomes. We wished to engender discussion and debate rather than provide a systematic review of existing literature. To this end, we think our aim has been achieved.


  • 1 School of Medicine, University of Queensland, Brisbane, QLD.
  • 2 School of Nursing and Midwifery, Griffith Health, Griffith University, Gold Coast, QLD.


Correspondence: sarah.winch@uq.edu.au

  • 1. Winch S, Henderson AJ. Making cars and making health care: a critical review. Med J Aust 2009; 191: 28-29. <MJA full text>
  • 2. Ben-Tovim DI, Dougherty ML, O’Connell TJ, McGrath KM. Patient journeys: the process of clinical redesign. Med J Aust 2008; 188 (6 Suppl): S14-S17. <MJA full text>
  • 3. Pellegrino ED. From medical ethics to a moral philosophy of the professions. In: Walter JK, Klein EP, editors. The story of bioethics. Washington, DC: Georgetown University Press, 2003.
  • 4. Tonelli M. Integrating evidence into clinical practice: an alternative to evidence-based approaches. J Eval Clin Pract 2006; 12: 248–256.
  • 5. Ritzer G, Walcak D. Rationalisation and deprofessionalisation of physicians. Soc Forces 1988; 67: 1-22.
  • 6. Ritzer G. The McDonaldization of society: an investigation into the changing character of contemporary social life. Thousand Oaks, Calif: Pine Forge Press, 1996.

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