This article and the comments here combine to illustrate for me the difficulty of making healthcare work in all the different ways it has to. I read the article, and I think, "Yeah! That's the kind of healthcare I want!" I read the comments with contrary opinions, and I think, "Those are great points — these counter-intuitive practices make sense when you need healthcare to scale." I talk to my wife, a physician, and I hear about what results in the rare cases when these protocols and consultations don't happen, and I think it's a wonder that hospitals function at all.

I think it's not a matter of finding the solution to the problem, but a maximization problem, where we have:

- patients who need to be cared for as human beings and allowed to make their own informed decisions, but who are generally not experts in medicine

- physicians who have more patients than they can keep in their minds at once, and who are reliant on nurses and computerized systems to keep patients breathing and not get sued, but who are also skilled, highly-educated professionals whose human judgment is frequently superior to any algorithm

- nurses who are both underpaid and responsible for more than their training considered

- hospitals that need to pay the bills, pay salaries, attract new physicians, etc.

There are so many conflicting aspects of this problem that any simple solution is probably unrealistic.