The highest form of medicine is to break the disease's pathogens

Sun Tzu said: In the practical art of war, the best thing of all is to take the enemy's country whole and intact; to shatter and destroy it is not so good. So, too, it is better to recapture an army entire than to destroy it, to capture a regiment, a detachment or a company entire than to destroy them.

Hence to fight and conquer in all your battles is not supreme excellence; supreme excellence consists in breaking the enemy's resistance without fighting.

Thus the highest form of generalship is to balk the enemy's plans; the next best is to prevent the junction of the enemy's forces; the next in order is to attack the enemy's army in the field; and the worst policy of all is to besiege walled cities.

From "Sun Tzu on the Art of War - The Oldest Military Treatise in the World"

Translated from the Chinese By Lionel Giles, M.A. (1910)
 

Discussion:

It goes naturally and needs few explanations. It matches the current emphasis on preventative medicine, community and outpatient care and non-invasive treatments. However, to call an operation "the worst policy of all" would be too harsh, so I changed it to "the least favourable policy of all" and referred to the most risky type of operation.

Translation:

It is generally recognised: In practice of healthcare, the best thing of all is to make full recovery with the whole body parts intact; to dissect and destroy the affected part is not so good. So, too, it is better to recover an organ entire than to remove it, to recover a tumour, a tissue or a cell entire than to destroy them.

Hence to perform and succeed in all your operations is not supreme excellence; supreme excellence consists in healing the disease's symptoms without operating.

Thus the highest form of medicine is to break the disease's pathogens; the next best is to prevent the junction of the disease's factors; the next in order is to treat the disease's symptoms in the outpatient setting; and the least favourable policy of all is to perform an operation under general anaesthesia.

Ray Murakami

Wise medical director makes a point of eliminating preventable medical errors

Hence a wise general makes a point of foraging on the enemy. One cartload of the enemy's provisions is equivalent to twenty of one's own, and likewise a single picul of his provender is equivalent to twenty from one's own store.

Now in order to kill the enemy, our men must be roused to anger; that there may be advantage from defeating the enemy, they must have their rewards.

Therefore in chariot fighting, when ten or more chariots have been taken, those should be rewarded who took the first. Our own flags should be substituted for those of the enemy, and the chariots mingled and used in conjunction with ours. The captured soldiers should be kindly treated and kept. This is called, using the conquered foe to augment one's own strength.

In war, then, let your great object be victory, not lengthy campaigns. Thus it may be known that the leader of armies is the arbiter of the people's fate, the man on whom it depends whether the nation shall be in peace or in peril.

From "Sun Tzu on the Art of War - The Oldest Military Treatise in the World"

Translated from the Chinese By Lionel Giles, M.A. (1910)
 

Discussion:

It was not easy to translate this last part of the second chapter, but they made senses when they were translated in the contexts of: preventing medical errors; preventive health intervension; improving emergency department throughput utilising inpatient facilities; and health reform by performance innovation. For the impact of preventable medical errors, the reference was the famous "To Err is Human: Building a Safer Health System" by the US Institute of Medicine.

 

Translation:

Hence a wise medical director makes a point of eliminating preventable medical errors. The deaths from preventable medical errors may reach tens of thousands cases and the total cost incurred may reach tens of billions dollars.

Now in order to fill the bed, our staff must be assigned to a patient; that there may be advantage from freeing beds, they must have their rewards.

Therefore in emergency treatment, when ten or more beds are taken from high dependency units  those should be awarded who took the first. ER patients should be transferred to beds from the units and new patients should be admitted. The captured beds should be carefully treated and kept. This is called, using inpatient facilities to enlarge emergency room capacity.

In health reform, let your great object be performance innovation, not lengthy campaigns. Thus it may be known that the leader of hospitals is the director of the people's welfare, the person on whom it depends whether the nation's health system shall be in peace or in peril.

Ray Murakami

Accessibility to high quality care causes health premiums to go up

On the other hand, the proximity of an army causes prices to go up; and high prices cause the people's substance to be drained away. When their substance is drained away, the peasantry will be afflicted by heavy exactions. With this loss of substance and exhaustion of strength, the homes of the people will be stripped bare, and three-tenths of their income will be dissipated; while government expenses for broken chariots, worn-out horses, breast-plates and helmets, bows and arrows, spears and shields, protective mantles, draught-oxen and heavy wagons, will amount to four-tenths of its total revenue.

From "Sun Tzu on the Art of War - The Oldest Military Treatise in the World"

Translated from the Chinese By Lionel Giles, M.A. (1910)

Discussion:

What is the equivalent for the proximity of an army in the health context is another difficult question. It should be something can be paired with the inefficiency in hospital care as another significant financial challenge in health management. Technical and financial advancements are improving accessibility to high quality care, but they are also pushing up national expenses on healthcare. So it is selected as another major challenge in health delivery comparable to the proximity of an army.

Translation:

On the other hand, the accessibility to high quality care causes health premiums to go up; and high premium causes the people's substance to be drained away. When their substance is drained away, the commerce will be afflicted by decreased demands.With this loss of substance and exhaustion of demand, the homes of the people will be stripped bare, and three-tenth of their income will be dissipated; while government expenses for healthcare, pension, welfare, nursing care and unemployment and disability benefits will amount to four-tenth of its total revenue.

Ray Murakami