Top positive review
12 people found this helpful
5.0 out of 5 starsHow We Can Provide Better Healthcare: True Stories to Motivate Us to Become Positive Deviants
ByJBrookson July 24, 2014
Loved this book. Read it twice. Very interesting true life examples. Anyone employed in a medical field or just interested would probably enjoy this. Book is divided into chapters each exploring a different concept and considering different points of view. Areas explored include:
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"
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 critical review
3.0 out of 5 starsGawande is a very good writer. Not as compelling as "Being Mortal
ByThe Heathon April 17, 2017
Interesting and Dr. Gawande is a very good writer. Not as compelling as "Being Mortal."
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5.0 out of 5 starsHow We Can Provide Better Healthcare: True Stories to Motivate Us to Become Positive Deviants
ByJBrookson July 24, 2014
Loved this book. Read it twice. Very interesting true life examples. Anyone employed in a medical field or just interested would probably enjoy this. Book is divided into chapters each exploring a different concept and considering different points of view. Areas explored include:
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"
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"
12 people found this helpful
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ByMarie Mon January 14, 2014
I highly recommend, Better: a Surgeon's Notes on Performance! I really enjoyed reading this book very intriguing and informative. I am aware some of the information the Author talked about. Two Chapters caught my attention Casualties of War and The Doctors of the Death Chamber. I wanted to write about the two subjects. I have strong opinions, on the two: Extremely controversial topics its best left alone.
On Washing Hands very crucial in hospital environment, Doctors, Nurses and staff need to wash their hands constantly to help stop the spread of infection. Each year two million Americans acquire an infection while they are in the hospital. That's just the tip of the iceberg.
I believe, a Surgeon's Notes on Performance, it is important for all of us to read. Especially, if you are planning on staying in the hospital for any length of time. Atul Gawande touched on so many important issues. I think, some reviewers gave elegant reviews. The reviewers are the ones, basically, sold me on getting this book. I' am so happy, I had the opportunity to read it. At the end of the book there are excellent Notes on Sources.
On Washing Hands very crucial in hospital environment, Doctors, Nurses and staff need to wash their hands constantly to help stop the spread of infection. Each year two million Americans acquire an infection while they are in the hospital. That's just the tip of the iceberg.
I believe, a Surgeon's Notes on Performance, it is important for all of us to read. Especially, if you are planning on staying in the hospital for any length of time. Atul Gawande touched on so many important issues. I think, some reviewers gave elegant reviews. The reviewers are the ones, basically, sold me on getting this book. I' am so happy, I had the opportunity to read it. At the end of the book there are excellent Notes on Sources.
I thought Atul Gawande's last book, Complications, was one of the best books written on the medical profession in a long while. In it, Gawande showed a deep respect and sympathy for patients while trying to be clear about what would help the medical establishment do a better job from a doctor's point of view. In this book, he covers some of the same ground but, as his title implies, here he is focused specifically on what it takes to do things better as a doctor. The chapters here are grouped under three big heading which Gawande feels are the categories of improvement: diligence, doing right, and ingenuity. Within that, he tells some fascinating stories.
Under diligence, he describes how simple persistence can improve performance significantly. For example, simple compliance with washing hands before and after each interaction with a patient would reduce unnecessary infections greatly and yet it is one of the poorest areas of performance in many medical establishment. My wife had a baby a couple weeks ago at a well-respected New York City hospital (that shall remain nameless) and, having read this book, I couldn't help but watch the hand washing. Though there was hand-washing going on, my anecdotal results were somewhat disappointing. It's scary. And yet, his stories of the effort to send polio the way of smallpox and the amazing success rates of medical teams in Iraq through no more than basic diligence with well-established methods give readers hope.
Under doing right, Gawande tells stories of the continuing debate over what constitutes right and wrong in medicine. What is the proper way to interact with someone who you have to examine naked? When is it fair to sue a doctor and how much is it worth? What should a doctor be paid for their services? Should a doctor participate in executions at prisons, considering the methods we use now are basically medical? When should a doctor continue treatment at all costs or let a patient die? These are questions with no easy answers and Gawande takes a balanced approach.
Under ingenuity, he discusses some simple, clever ideas that have helped improve performance in various areas. His wonderful chapter on childbirth focuses on the Apgar score for newborns. As most know, this is a number ubiquitous now at the birth of a baby. It wasn't even developed by an OB/GYN. It was developed by an anaesthesiologist. It required no new medical techniques. It simply required doctors and nurses to do a directed assessment of a baby at birth. And yet, this simple, ingenious change, dropped child mortality rates significantly as babies previously thought to have no chance were given a chance and hospitals competed to "improve" their Apgar scores. In this section he also has a discussion on how true analysis of doctor and hospital performance is rare but, when used, greatly improves success as well as a discussion of the amazing cleverness of doctors in the poorest parts of the world to do procedures with limited equipment. It was incredibly eye-opening.
It is a fact of life that all of us will have to encounter the medical establishment from time to time. It can be incredibly frustrating. Still, it's nice to know that there are doctors like Gawande trying to understand things and make them better. In addition, he is a fine writer who has a wealth of interesting history and personal anecdotes that help make his ideas clear. Everyone should take some time and read his work.
Under diligence, he describes how simple persistence can improve performance significantly. For example, simple compliance with washing hands before and after each interaction with a patient would reduce unnecessary infections greatly and yet it is one of the poorest areas of performance in many medical establishment. My wife had a baby a couple weeks ago at a well-respected New York City hospital (that shall remain nameless) and, having read this book, I couldn't help but watch the hand washing. Though there was hand-washing going on, my anecdotal results were somewhat disappointing. It's scary. And yet, his stories of the effort to send polio the way of smallpox and the amazing success rates of medical teams in Iraq through no more than basic diligence with well-established methods give readers hope.
Under doing right, Gawande tells stories of the continuing debate over what constitutes right and wrong in medicine. What is the proper way to interact with someone who you have to examine naked? When is it fair to sue a doctor and how much is it worth? What should a doctor be paid for their services? Should a doctor participate in executions at prisons, considering the methods we use now are basically medical? When should a doctor continue treatment at all costs or let a patient die? These are questions with no easy answers and Gawande takes a balanced approach.
Under ingenuity, he discusses some simple, clever ideas that have helped improve performance in various areas. His wonderful chapter on childbirth focuses on the Apgar score for newborns. As most know, this is a number ubiquitous now at the birth of a baby. It wasn't even developed by an OB/GYN. It was developed by an anaesthesiologist. It required no new medical techniques. It simply required doctors and nurses to do a directed assessment of a baby at birth. And yet, this simple, ingenious change, dropped child mortality rates significantly as babies previously thought to have no chance were given a chance and hospitals competed to "improve" their Apgar scores. In this section he also has a discussion on how true analysis of doctor and hospital performance is rare but, when used, greatly improves success as well as a discussion of the amazing cleverness of doctors in the poorest parts of the world to do procedures with limited equipment. It was incredibly eye-opening.
It is a fact of life that all of us will have to encounter the medical establishment from time to time. It can be incredibly frustrating. Still, it's nice to know that there are doctors like Gawande trying to understand things and make them better. In addition, he is a fine writer who has a wealth of interesting history and personal anecdotes that help make his ideas clear. Everyone should take some time and read his work.
Bytirza sandbankon September 8, 2017
I enjoy everything that Atul Gawande writes. He writes vividly, he is both a great storyteller and a very wise and self reflecting man. He writes so intelligently and frankly about the dilemmas of medicine. This is excellent reading in every way, informative, intriguing and thought provoking.
Byalgo41on June 17, 2008
Better" is as good as Gawande's first book. Gawande is interested in the improvement of medical practice, and he combines personal experiences and observations with a study of best practices by others. He is obviously comfortable in interviewing both patients and doctors, as well as being brilliant and an entertaining writer.
As it happens, only because his daughter urged him, he got a second opinion on her psoriasis, and it was cleared up with a common antibiotic. I am sure Gawande had researched her problem, so this illustrates the point he makes later that there is a need for more informal write-ups of things which seem to work. My daughter had a similar experience with a different problem. I was surprised to learn that he expects 2% of his surgeries to go wrong: either there will be life threatening bleeding, or collateral damage like harm to a critical nerve, or a wrong diagnosis.
I enjoyed some chapters more than others, but I have no confidence my rankings will correspond to those of other readers. Anyway, I liked most the chapters on the problems in implementing better hand washing; how treatment of Iraq war wounds was dramatically improved; medical malpractice; medical care in India; and, my favorite, the chapter on the bell curve as illustrated by treatment for cystic fibrosis. I think Gawande really has something in suggesting that the U.S. handle inadvertent harm by doctors as it does harm from vaccines. However, like with unemployment insurance, doctors and hospitals should have to pay more into the fund if their history has been bad.
As it happens, only because his daughter urged him, he got a second opinion on her psoriasis, and it was cleared up with a common antibiotic. I am sure Gawande had researched her problem, so this illustrates the point he makes later that there is a need for more informal write-ups of things which seem to work. My daughter had a similar experience with a different problem. I was surprised to learn that he expects 2% of his surgeries to go wrong: either there will be life threatening bleeding, or collateral damage like harm to a critical nerve, or a wrong diagnosis.
I enjoyed some chapters more than others, but I have no confidence my rankings will correspond to those of other readers. Anyway, I liked most the chapters on the problems in implementing better hand washing; how treatment of Iraq war wounds was dramatically improved; medical malpractice; medical care in India; and, my favorite, the chapter on the bell curve as illustrated by treatment for cystic fibrosis. I think Gawande really has something in suggesting that the U.S. handle inadvertent harm by doctors as it does harm from vaccines. However, like with unemployment insurance, doctors and hospitals should have to pay more into the fund if their history has been bad.
ByPatCSon December 2, 2017
This is a brilliant book, really an essay on the vital importance of creative thinking and perseverance. I’ve enjoyed all of Gawande’s books as individual works of art and intelligence!
ByDonna Carteron September 9, 2016
This is a can't put down analysis of deep medically directed thinking, critical thinking, and medical analysis all conveyed in a constantly compelling high level of creative writing energy. Fast flow of medical insight in what makes for medical excellence in patient care scenarios All meant to challenge the reader to be the BEST in all they do! Loved this book as much as Dr. Garrande's other wonderful writing!
BySkyleron August 30, 2017
Really fascinating book. Amazing behind the scenes in hospitals, and of the lives of these exhausted, over-worked medical professionals.
ByC. Nelsonon August 10, 2015
Wow! What a thoughtful book! Each chapter describes an issue in medicine and how individuals or communities brought about positive change. The book covers topics including hand washing, malpractice, Apgar scores, the treatment of individuals with cystic fibrosis, and surgery in India. At the end of the book, Gawande offers five useful and doable suggestions for improving performance in any field. I've recommended this book to many people.
Bykneeon January 17, 2017
One of the most exceptional books I've read. Read both of Atul Gawande's books on medicine. He writes in a vivid, easy to read, exciting and moving way. I loved this book.
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