Atul Gawande
Atul Gawande
Atul Gawandeis an American surgeon, writer, and public health researcher. He practices general and endocrine surgery at Brigham and Women's Hospital in Boston, Massachusetts. He is also a professor in the Department of Health Policy and Management at the Harvard T.H. Chan School of Public Health and the Samuel O. Thier Professor of Surgery at Harvard Medical School. In public health, he is executive director of Ariadne Labs, a joint center for health systems innovation, and also chairman of Lifebox,...
NationalityAmerican
ProfessionJournalist
Date of Birth5 November 1965
CityBrooklyn, NY
CountryUnited States of America
In one study, old people assigned to a geriatrics team stayed independent for far longer, and were admitted to the hospital less.
Culture matters. Of course, if physicians are rewarded or penalized for their service and results, the culture will change. But the key values we doctors are being pressed to embrace are humility, teamwork, and discipline.
I think the extreme complexity of medicine has become more than an individual clinician can handle. But not more than teams of clinicians can handle.
Just using a checklist requires [doctors] to embrace different values from ones we've had, like humility, discipline, teamwork.
As economists have often pointed out, we pay doctors for quantity, not quality. As they point out less often, we also pay them as individuals, rather than as members of a team working together for their patients. Both practices have made for serious problems.
You can't make a recipe for something as complicated as surgery. Instead, you can make a recipe for how to have a team that's prepared for the unexpected.
Over time I learned that there are two very different satisfactions that you can have in your life. One is the satisfaction of becoming skilled at something. It almost doesn't matter what the terrain is. There is a deep, soul-feeding resonance in mastery itself, whether in teaching, writing a complicated software program, coaching a baseball team, or marshalling a group of people to start a new business...
The vast majority of doctors really do try to take the money out of their minds. But to provide the best possible care requires using resources in a way that keeps you viable but improves the quality of care.
The health-care sector certainly employs more people and more machines than it did. But there have been no great strides in service. In Western Europe, most primary-care practices now use electronic health records and offer after-hours care; in the United States, most don't.
People say that the most expensive piece of medical equipment is the doctor's pen. It's not that we make all the money. It's that we order all the money.
Health care confronts us with a difficult test. We have never corrected failure in something so deeply embedded in people's lives and in the economy without the pressure of an outright crisis.
Doctors quickly learn that how much they make has little to do with how good they are. It largely depends on how they handle the business side of their practice.
Our health-care morass is like the problems of global warming and the national debt - the kind of vast policy failure that is far easier to get into than to get out of. Americans say that they want leaders who will take on these problems.
My vantage point on the world is the operating room where I see my patients.