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Are doctors who make mistakes villains? No, because then we all are.

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
Villains
Villain
Doctors
Mistakes
Mistake
Make

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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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Coaching done well may be the most effective intervention designed for human performance.
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Culture matters. Of course, if physicians are rewarded or penalized for their service and results, the culture will change. But the key values we doctors are being pressed to embrace are humility, teamwork, and discipline.
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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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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.
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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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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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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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We have medicalized aging, and that experiment is failing us.
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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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Writing lets you step back and think through a problem. Even the angriest rant forces the writer to achieve a degree of thoughtfulness.
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Life is choices, and they are relentless. No sooner have you made one choice than another is upon you.
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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.
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Human interaction is the key force in overcoming resistance and speeding change.
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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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Arriving at an acceptance of one's mortality is a process, not an epiphany.
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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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When we, doctors, ask patients what their priorities are if time is short, what we do is we use what is available to us - whether it's geriatric care or palliative care or hospice care - to make sure they're living the kind of life that they want to live.
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I think the extreme complexity of medicine has become more than an individual clinician can handle. But not more than teams of clinicians can handle.
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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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