A story about war can teach about making the right choices for your practice.
I read the Bomber Mafia by Malcolm Gladwell, which weaves a riveting tail of persistence, innovation, and costs of waging war. In this book he describes the World War II story of supplying fuel to B-29 bombers for the invasion of Japan in 1942. The Indian city closest to Japan was Kolkata (Calcutta) located in the eastern India. The planes with the fuel would fly to an airfield in Chengdu, China. The planes would refuel in Chengdu and fly to Japan to drop bombs on military and industrial sites that were supporting their war effort. After dropping their bombs, the planes would return to Chengdu pick up fuel and return to Kolkata to repeat the process.
Now the cost-benefit of this attempt to provide fuel for the B-29 bombers. The Himalayas are located between Kolkata and Chengdu making the flight over the mountains very dangerous. Nearly 700 B-29 bombers crashed while trying to navigate over the Himalayas. At issue was that it took twelve gallons of B-29 gasoline to bring just once gallon of fuel over the mountains.
It gets even worse. On June 13, 1944, ninety-two B-29s took off from Kolkata and only seventy-nine made it to Chengdu. Only one plane was able to hit the target of a steelwork’s facility in southern Japan! The Allied command concluded that it was insane to spend twelve gallons of aviation fuel to go over the mountains to deliver one gallon of gas to the other side. The take home message was that this great cost offered minimal benefit.
So, what does this story have to do with the healthcare profession?
Just as any business including the military, government, and healthcare must weigh the cost of implementing a new idea or technology and consider the benefits from such a decision. The cost-benefit analysis (CBA) is a systematic approach for evaluating the economic feasibility of a project or decision by comparing the costs and benefits associated with it. In the healthcare industry, CBA plays a crucial role in assessing the value of various interventions, programs, technologies, and policies. Here are some examples of cost-benefit analysis in the healthcare sector:
Preventive health screenings:
Marketing and practice promotion:
Chronic disease management programs:
Bottom Line: In each of these examples, a thorough cost-benefit analysis conducted prior to implementation of a new program, technology, and interventions would involve quantifying both the direct and indirect costs and benefits, considering factors such as long-term outcomes, societal impact, and the time value of money.
Neil Baum, MD, a Professor of Clinical Urology at Tulane University in New Orleans, LA. Dr. Baum is the author of several books, including the best-selling book, Marketing Your Medical Practice-Ethically, Effectively, and Economically, which has sold over 225,000 copies and has been translated into Spanish.