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The presentation explores thinking and practice in health care on the problem of operational efficiency. Beginning with Frederick Taylor's principles of scientific management and their application to the assembly-line, the presentation utilizes brief case studies in which the human factors traditionally excluded from economies of industrial production, may be seen as highly relevant to the organization of health care. The case studies offer valuable comparisons between efficiency goals and unintended consequences in which 'the human factor' plays a large role. Examples range from production at Dell Computers to the very humane efficiencies of the Shouldice Hospital and their implications for practice elsewhere.