- File Size: 542 KB
- Print Length: 292 pages
- Publisher: Metropolitan Books; 1st edition (January 22, 2008)
- Publication Date: January 22, 2008
- Sold by: Macmillan
- Language: English
- ASIN: B000QCSAB8
- Text-to-Speech: Enabled
- Word Wise: Enabled
- Lending: Not Enabled
- Amazon Best Sellers Rank: #58,693 Paid in Kindle Store (See Top 100 Paid in Kindle Store)
Better: A Surgeon's Notes on Performance 1st Edition, Kindle Edition
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- Length: 292 pages
- Word Wise: Enabled
- Enhanced Typesetting: Enabled
- Page Flip: Enabled
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The key theme is that medical success is influenced more by drivers other than the doctor’s skill and training, or availability of equipment and drugs. And these drivers are not glamorous, but include such humdrum things as diligence and persistence.
What is amazing about the book is that the themes are just as applicable in my world - of risk management in financial services - as in medicine. In my 57 years of life, which include 23+ years in risk management, I have seen how simple, mundane DILIGENCE, for example, can cure a lot of ills in companies big and small, including miscommunication, loss of morale and motivation, lack of innovation and entrepreneurship. Ditto simple, mundane, motivated persistence, which the author calls FIGHTING and INGENUITY. This author has definitely tuned into something that demonstrably improves medicine, but, in my view, can improve any individual or collective human effort.
The only gap I can think of is this: Healthcare in the United States is broken, and a big reason is the heavy hand of the shallower forms of commercial interests, which eclipse the entrepreneurship, innovation, humaneness, and efficiency that human effort otherwise produces. But I am encouraged that the author has agreed to lead Haven, a healthcare joint venture of J.P. Morgan Chase, Amazon, and Berkshire Hathaway. Haven presents a hope that US healthcare will be repaired.
achieving handwashing by healthcare workers to reduce the spread of infections,
attempts to erradicate polio in India by chasing hotspots,
reducing mortality in the Iraq/Afghanistan wars by new strategies of battlefield care,
aspects of chaperones for intimate physical examinations,
different systems for physician compensation,
ways to reform our malpractice laws,
the inhumaness of execution methods and the ethics that prevent physicians from participating,
development of Apgar scores and how they have reduced newborn mortality,
and examples of how doctors and facilities that are highly specialized show better outcomes.
The author explores how significant innovations have been made by those who investigate new approaches and are committed to improvement and how we should all strive to make improvements within our personal niche in healthcare. "How to Become a Positive Deviant"
Top international reviews
Gawande writes very well and no piece lacks interest - thought some hold more interest than others. Coming to this after Being Mortal and The Checklist Manifesto, the book suffers a little by comparison. There's no overarching theme here to match the 'take-aways' from those extended discussions of a single topic. But Gawande's concluding reflections on why he writes - so as not to be just one cog in a machine but engage with the world directly and at scale - make perfect sense. And he certainly succeeds here - it's just that he'll succeed even more later...
I am a fan of his work anyway so was confident I would enjoy this book.
As I work with people who have English as a second language there are often concerns about misunderstandings, I find that I am attracted to books that define terms that we all thought we knew already. They give an insight into the complexity of a topic and remind me that even between native speakers we can interpret what something means differently.
A great read for people wanting to discuss what better means for their work.
I am a physician and enjoyed it but it is must read for all surgeons