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Expertise is the mantra of modern medicine.

Atul Gawande

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Atul Gawande
Age: 59
Born: 1965
Born: May 11
Journalist
Medical Writer
Professor
Researcher
Surgeon
Brooklyn
New York
Atul A Gawande
Atul Gawande
Mantra
Mantras
Expertise
Medicine
Modern

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You know, 97 percent of the time, if you come into a hospital, everything goes well. But three percent of the time, we have major complications.
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Man is fallible, but maybe men are less so.
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We recruit for attitude and train for skill.
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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.
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We yearn for frictionless, technological solutions. But people talking to people is still the way norms and standards change.
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I learned about a lot of things in medical school, but mortality wasn't one of them.
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If I became just a brain in a jar - as long as I can communicate back and forth with people, that would be okay with me.
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This is the reality of intensive care: at any point, we are as apt to harm as we are to heal.
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Human interaction is the key force in overcoming resistance and speeding change.
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What about regular professionals, who just want to do what they do as well as they can?
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We have medicalized aging, and that experiment is failing us.
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One of the consequences of if the Affordable Care Act is repealed, is that all of us now are at risk of being a preexisting - of having a preexisting condition waiting to happen. Life, increasingly, is a preexisting condition waiting to happen, now that we have more and more of this data available.
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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.
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People who reach certain levels of frailty, more important than getting their mammogram, more important than getting their blood pressure tweaked, they're at high risk of falling. If they fall and break their hip, they not only die sooner, they die miserably.
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Are doctors who make mistakes villains? No, because then we all are.
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A failure often does not have to be a failure at all. However, you have to be ready for it-will you admit when things go wrong? Will you take steps to set them right?-because the difference between triumph and defeat, you'll find, isn't about willingness to take risks. It's about mastery of rescue.
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Coaching done well may be the most effective intervention designed for human performance.
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Checklists turn out...to be among the basic tools of the quality and productivity revolution in aviation, engineering, construction - in virtually every field combining high risk and complexity. Checklists seem lowly and simplistic, but they help fill in for the gaps in our brains and between our brains.
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You want to ensure people can do it right 99 percent of time. When we have to fire one of our surgical trainees, it is never because they dont have the physical skills but because they dont have the moral skills - to practise and admit failure.
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Arriving at an acceptance of one's mortality is a process, not an epiphany.
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