Thursday, August 1, 2013

Book Review- Better: A Sugeon's Notes On Performance by Atul Gawande

I read this book on a recommendation from a Nurse Practitioner where I work and though it was a bit slow at times, I really think this author has some important things to say. I haven't read anything else by him, but he has several books out with some overlapping themes. In this particular book, as the name implies, he takes a look at performance in the medical field, across several different areas and offers suggestions for how everyone can improve. Though this is health care centric, there are definitely some suggestions we all can take away and bring into our work and home lives.

At the start, he identifies three core requirements for success in medicine or any endeavor. The first requirement is diligence, which he describes as the necessity of giving sufficient attention to detail to avoid error and prevail against obstacles. The second requirement is to do due right. The third requirement is ingenuity or thinking anew. Across the book, he uses stories of his own experience or the experiences of others to make his points. He is fairly honest with himself and his failings which is refreshing, but he also literally travels around the world to compare and contrast what we do here versus how things are done elsewhere in the world. THAT was eye opening for me.

The first part dealing with diligence is pretty straightforward and was one of the slower parts of the book for me. In general, he makes the case for what should be common sense, namely that we pay close attention. Some of this stuff is kind of inside baseball in the world of medicine. We know what should be done but frequently find reasons not to do it because it is time consuming, expensive and at times, exhausting. He doesn't offer many suggestions in the front part of the book for how to deal with this, but in the end there were other suggestions. After the first part of the book, the remaining to sections were what really drew me in.

In the second section, he talks about doing right and this left me with some things to think about. While he discussed some things about litigation that weren't all that interesting to me, he made a point about our healthcare system which is that despite how advanced the care we provide is, our delivery of that care is a big failure. I agree. Other notable quotes were "Having a machine is not the cure; understanding the ordinary, mundane details that go right for each particular problem is". The other quote was, " New laboratory science is not the key to saving lives. The infant science of improving performance, of implementing our existing know how is."

After making his points, he offers five suggestions to be an agent of change and I think you can apply these anywhere really. The first is, "Ask an unscripted question". In this venue, he is talking about medicine, but once he started to do this, he found out incredible things about people he worked with that he never knew. That by itself didn't change anything, but it does allow you to make a human connection. I believe all of us here could benefit from this. The second suggestion was don't complain. Again, in the venue he is describing, the doctor is often the one that people are going to look up to and if they are bitching, everyone else will too. I bitch a lot here and at times, I do at work. I could do a lot less of it and hopefully this will stick with me for awhile. Coupled with this, he suggested that whenever you are in a group of people, try to keep bringing things up that are positive.

The third suggestion is, "Count Something". Basically, always been observing the world around you with a scientific eye. You don't need to conduct heavy duty research, but always be interested in what goes on around you. I think we excel at this here. The fourth suggestion is "Write Something". It doesn't need to be published, but even just showing up on a blog and commenting something positive may have an impact you never know. The last suggestion was "Change" In simple terms, grow. Challenge your views and when something better comes along, don't be afraid to adopt it. This is quite difficult.

That's a lot to say I guess, but I think this book is a decent read for summer and is not complicated and is not very long. I knocked it out in about three days on the kindle.

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