Hughes Jordan, Kale Neelima, Day Philip
University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Department of Family and Community Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Fam Med Community Health. 2019 Jan 24;7(1):e000069. doi: 10.1136/fmch-2018-000069. eCollection 2019.
Principles and practices gleaned from successful business enterprises have been used to transform the practice of medicine for decades. McDonaldization is the process in which principles which govern fast-food businesses, are applied to the practice of medicine. When left unchecked, the application of these principles can have devastating consequences, as in the treatment of chronic, non-malignant pain with OxyContin. At a time when there was growing concern about the under treatment of pain, Purdue Pharma introduced OxyContin, providing an efficient, predictable way of treating chronic pain. The liberal prescription of this drug contributed, and continues to contribute, to the opioid epidemic we see today. So, in confronting this epidemic, we must first understand the process of McDonaldization that has brought us here and then provide safe and effective chronic pain therapies even if they are expensive, time-consuming to deliver, difficult to measure, and unpredictable in their outcomes-all things we've grown to detest in our McDonaldized healthcare system.
几十年来，从成功的商业企业中汲取的原则和做法被用于改变医疗实践。麦当劳化是指将管理快餐企业的原则应用于医疗实践的过程。如果不加以控制，这些原则的应用可能会产生毁灭性后果，比如使用奥施康定治疗慢性非恶性疼痛。在人们对疼痛治疗不足的担忧日益加剧之际，普渡制药推出了奥施康定，提供了一种有效、可预测的慢性疼痛治疗方法。这种药物的大量处方导致并持续导致了我们如今看到的阿片类药物流行。所以，在应对这一流行趋势时，我们必须首先了解将我们带到这一步的麦当劳化过程，然后提供安全有效的慢性疼痛治疗方法，即便它们成本高昂、提供过程耗时、难以衡量且效果不可预测——而这些都是我们在麦当劳化的医疗体系中越来越厌恶的情况。
