Transparency, diligence - engines of innovation

books:


	• Better: A Surgeon's Notes on Performance Atul Gawande Picador, 2008 - 288 pages average customer review:based on 81 reviews view larger image
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highly recommended

A paean to diligence

Atul Gawande's second collection of essays from The New Yorker continues in the same style as his debut, Complications. While the book covers such diverse topics as hand-washing practices among hospital caregivers, vaccination efforts in third world countries, physician-patient relationships and etiquette in various international settings, medical personnel participating in state executions, and malpractice law, the overarching theme of the collection is Gawande's view of clinical medicine as both a science and an art.

Not discounting the central importance of scientific research and innovation, Gawande emphasizes that the most common of life-threatening mistakes occur not due to a lack of scientific understanding of a particular problem but rather a lack of diligence in adhering to practices and procedures that are elementary and thus easily forgotten. To the general public the words "modern medicine" are synonymous with expensive machinery and cutting-edge pharmaceutical therapies but the fact is that far more people in the US and around the world die because of iatrogenic drug-resistant pneumonias than high-grade gliomas (which is not a call-to-arms for gifted, savant doctors but a plea for diligence and discipline from every participant in the continuum of care). Of course the virulence of those infections has been increasing recently but that too can be linked to a lack of diligence in treatment -- excessive antibiotic prescription, inadequate antiseptic practices.

Gawande is bothered by the idea that medicine can be such a theater for technological prowess while simultaneously facing a breakdown in logistics that causes a consistent percentage of patients to receive the wrong medication every day. Here he calls for new systems of internal study and review so that performance can one day match our capabilities. If you enjoy Oliver Sacks and other clinical writing, you will appreciate this book.

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A Straightforward and Thought-Provoking Work

Atul Gawande's second book is the first work I've read that falls under that bookstore subcategory of "Medical Literature." It's one of those books that can stimulate an interest for a subject in an initially less-than-curious reader. Firstly, Dr. Gawande's prose is very straightforward and approachable; his descriptions are nontechnical without sacrificing detail. Many chapters address issues to which the average person often has knee-jerk reactions to, such as medical malpractice. There are also quite enlightening passages: I for one have always been curious about how the current system for compensation for medical services came about.

Perhaps the strongest feature of Dr. Gawande's writing is the presentation of multiple perspectives, complete with interviews, example cases, and history. The author does not try to hammer his views across, but presents issues that the average reader might not have ever thought too deeply about. By providing a complete framework of an issue, the reader is then able to consider the subject from multiple angles.

The book is a fast read, a credit to the author's writing ability. The material really does keep you thinking long after you've put down the book, and I think that's why it deserves a 5th star in spite of the apparent short length. After all, there are so many books longer in length that, while enjoyable, do not lead to long moments of introspection during quiet times. "Better" is a book that first makes you think, and when you aren't satisfied with what you know so far, makes you go out to learn more on your own.

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Appreciate life and do better!

The title of this book is great. Gawande's notes on performance will provide a lot of information. He writes about malpractice headaches, insurance obstacles, medical resources in the war and how medical teams have helped so many soldiers. He also mentions a physicians role in the death penalty (that there shouldn't be one) and tells the reader a little about the history of executions. He also provides some history of childbirth and history of tools used. I found out about an inspirational woman named Virginia Apgar too by reading this book. The "fighting on" section did make me emotional and I'm so glad I wasn't somewhere public while reading it.

Every bit of the way Gawande provides nice advice for anyone, not just doctors, to do better.

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Transparency, diligence - engines of innovation

Constantly bombarded by the latest headlines in advances of genomics research, new drugs, and ever sophisticated machinery to help save human lives, Atul Gawande's book offers an insightful suggestion: diligence, transparency, and focus on data-driven improvement, on the part of the doctor, may well be the next frontiers if we're looking to transform the healthcare industry.

Science helps, but ingenuity, and diligence of the doctor are often overlooked and underestimated. Having no affiliation to the healthcare industry, this book has definitely brought me to re-evaluate my relationship with my doctor, and gave me a much better understanding of what to look for in the future.

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Excellent Book

I enjoyed Gawande full view on the topics in medicine that he discussed. It gave me a great feel for the field and also left room for the reader to be critical and think of additional ways of how to make the problems within medicine better

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