Tracking our collective performance means that a bell curve will emerge it also means that we will improve what we do for our patients and improve the quality of our own professional lives. In order to go to the next level where it’s better experience for the patients and we are more likely to deliver good care consistently and have a better experience for us, I think we have to measure how we’re doing. That worked in simple matters, but as medicine became more complex, we had high failure rates. We went from a world where we were mainly artisans, and that meant you simply did what you could. In an interview with AMA News last summer, the author pointed out the corollary to the bell curve: 1 Gawande has it dead-on right in my opinion, and the sooner we all come to grips with this reality, the better. In fact, when we do measure what we do every day, a bell curve of performance emerges. In the nearly 60 years of organizational research on quality measurement and safety improvement that has occurred since World War II, we have collectively learned that we improve only processes that we measure. Will being in the bottom half be used against doctors? Will we be expected to tell our patients how we score? Will patients leave us? Will those at the bottom be paid less than those at the top? The answer to all these questions is likely, yes.” Once we acknowledge that no matter how much we improve our average, the bell curve isn’t going away, we’re left with all sorts of questions. In Better, he confronts these myths head-on, and his message is clearly relevant for every P&T committee member in the nation.įor example, my favorite chapter in Better is called “The Bell Curve” (in Part III, “Ingenuity”). What I like about his books, in addition to the incisive writing, is his unflinching willingness to confront many of our most tightly held myths about medical practice. He also happens to be a Harvard-trained surgeon, and he is now a Harvard Medical School faculty member (a real low achiever!).

Gawande is a 2006 MacArthur Fellow, a recipient of one of those national “genius awards” handed out annually to somebody who makes a major difference in our society. My interest continues with his latest book, Better: A Surgeon’s Notes on Performance, published by Henry Holt and Company.ĭr. This book became a finalist for the 2002 National Book Award. My fascination with his work started in 2002 with the publication of his first book, Complications: A Surgeon’s Notes on an Imperfect Science.

I have to admit it I’m a real fan of Atul Gawande, MD, MPH, and his insightful best-sellers.

Complications atul gawande review