Tuesday, January 13, 2009

Atul Gawande: better

Atul Gawande is my kind of surgeon. He is not content to just be a doctor, he needs to know why doctors do what they do, how they can be better at doing what they do, and as if that's not enough, he also feels compelled to write about it. I guess I can relate. There's something about going through the motions, or doing your job without thinking about it that just isn't enough for me or Gawande. Which is why "better" was a great read.

I'm pretty sure I've read parts of it in the New Yorker, like, if everyone in the hospital washed their hands every time they were supposed to, incidences of bacterial infection would decline precipitously, but it was so good that I read it again. And the section about innovations in wartime medicine and the ethical problems these innovations raise- if we save soldiers' lives, but leave them with one functioning appendage and no eyes, what kind of quality of life will they have, and where are the innovations to help them live a good life- was totally new and thought provoking. Gawande has a fascinating chapter about keeping score- basically, allowing patients to know where their treatment centers rank in comparison with other, similar treatment centers. He follows up with the million dollar question: what does this mean for practitioners? What if you are the "average" doctor? Will this affect the amount of patients that come to your practice? Will it mean you can't charge as much for your services? What does it mean to be average? When is average ok, and when isn't it?

This book is extremely though provoking, in a thorough, understated way. You don't have to be a doctor to care about medicine and the great health care system morass. And you don't have to be a surgeon to want to be "better" in your field. I think Gawande is my new hero. Ok, at least an author I'm going to follow for awhile.


Katie said...

His book Complications was also really good. Thought-provoking.