Surgeon by day and public health journalist by night, Atul Gawande explores how doctors can dramatically improve their practice using something as simple as a checklist.
A general and endocrine surgeon at Brigham and Women’s Hospital in Boston, Atul Gawande is also a staff writer at The New Yorker who's changing the way we think about best practices in medicine (and, necessarily, about the state of the US healthcare system). In 1996 Gawande wrote his first piece for Slate, an analysis of the then-controversial illness known as Gulf War Syndrome. At The New Yorker, he turned in a shocking June 2009 piece, “The Cost Conundrum,” about McAllen, Texas, the town with the second most expensive health-care market in the U.S., taking on America’s high-cost low-quality healthcare system. (The piece was cited by President Obama during his campaign for healthcare reform.)
Gawande approaches medicine with a personal outlook, emphasizing the importance of a doctor’s intention and reliability, and urging doctors to make small changes to improve performance. In his most recent book, The Checklist Manifesto, Gawande shows how even a simple five-point checklist can decrease up to two-thirds of ICU infections. He suggests that as modern medicine -- and indeed, the modern world -- becomes increasingly complex, we should respond with ever-simpler measures.
In the fall of 2012, Gawande founded Ariadne Labs, a center for health systems innovation run through Harvard and the Brigham and Women's Hospital. The Labs are working to create more efficient, higher quality health care while simplifying the whole system.
“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.”
“Making systems work is the great task of my generation of physicians and scientists. But I would go further and say that making systems work — whether in healthcare, education, climate change, making a pathway out of poverty — is the great task of our generation as a whole.”
“[The pre-penicillin era] was when the core structure of medicine was created. … It was at a time when what was known, you could know. You could hold it all in your head and you could do it all.”
“[In medicine,] we have trained, hired and rewarded people to be cowboys, but it's pit crews that we need.”
“Having great components is not enough, and yet we've been obsessed in medicine with components. We want the best drugs, the best technologies, the best specialists, but we don't think too much about how it all comes together.”
“Just using a checklist requires [doctors] to embrace different values from ones we've had, like humility, discipline, teamwork.”