Quotes: Atul Gawande

Five rules for the class of 2005:
1) Ask an unscripted question
2) Don't whine
3) Count something
4) Write something
5) Change,
...To have a good life in medicine

Physician Autonomy: (Excerpt from "The checklist manifesto - How to get things right" Atul Gawande. Metropolitan books 2009)
p 65: ...the medical way of dealing with extreme complexity - with inevitable nuances of an individual patient case - is to leave them to the expert's individual judgement. You give the specialist autonomy. In this instance, Rouillard was the specialist. Had the building site been a hospital ward, his personal judgement would hold sway.

This approach has a flaw, however, O'Sullivan pointed out. Like a patient, a building involves multiple specialists - the sixteen trades. In the absence of a true Master Builder - a supreme all-knowing expert with command of all existing knowledge - autonomy is a disaster. It produces only a cacophony of incompatible decisions and overlooked errors. You get a building that doesn't stand up straight. This sounded to me like medicine at its worst....

p67: ...Man is fallible, but may be men are less so...

No comments: