intro’d to Atul via Liz recommending .. being mortal
his ted2012 – how do we heal medicine
6 min – in 1970..took just over two full-time equivs of clinicians..nursing time and little bit for a dr..more/less checked in once/day..by end of the 20th cent..more than 15 clinicians for same typical hospital patient..specialists..physical therapists..nurses
7 min – our experience as people who get sick..need help..is that we have amazing clinicians ..incredible techs..but little sense that it consistently all comes together for you from start to finish in a successful way
9 min – we found that the most expensive care is not necessarily the best care.. and best care turns out to be least.. and what that means is.. there’s hope.. don’t have to ration medicare…
10 min – when we look at best results… *the ones that look the most like systems are the most successful.. found ways to get all components/pieces to come together as a whole…they found ways to get all of diff pieces/components to come together into a whole..
having great components is not enough..and yet we’ve been obsessed in medicine with components…terrible design strategy
skill one..find where failures are
skill two..devise solutions
there’s a deep resistance (to implementation) because using these tools forces us to confront that we’re not a system..to behave with a diff set of values
ted 2017 – want to get great at something get a coach
Just watch it. @Atul_Gawande is so amazing: https://t.co/uf9FDsGdTS
Original Tweet: https://twitter.com/HelenWalters/status/941749805776363521
how people improve in the face of complexity.. or don’t..
birth.. 22 drugs on site
how do professionals get better at what they do:
1\ traditional pedagogical.. go to school..prof capable of managing own improvement.. the thing is it works.. tutors..inculcating ways of thinking and learning to can do it on own when done
2\ sports.. say you are never done.. everyone needs a coach.. so to me.. pay someone to come into my room and have them observe me.. seems absurd..
asked perlman.. why don’t violinists have coaches.. and he said.. i don’t know.. but i always had a coach.. his wife.. to listen and give feedback
turns out there are numerous problems on making it on your own.. somewhere along the way.. you stop improving..
coaches – external eyes and ears
coaches were onto something profoundly important..
MacArthur Foundation (@macfound) tweeted at 7:01 AM – 23 Dec 2017 :
#MacFellow @Atul_Gawande on how clinicians can better collaborate using systems: https://t.co/eqmy64ItAy via @NPR (http://twitter.com/macfound/status/944568526160793600?s=17)
links to his ted on coaches
Surgeon, Writer, Researcher, Dilettante.
Atul Gawande (born November 5, 1965) is an American surgeon, writer, and public health researcher. He practices general and endocrine surgery at Brigham and Women’s Hospital in Boston, Massachusetts. He is a professor in the Department of Health Policy and Management at the Harvard T.H. Chan School of Public Healthand the Samuel O. Thier Professor of Surgery at Harvard Medical School. In public health, he is executive director of Ariadne Labs, a joint center for health systems innovation, and chairman of Lifebox, a nonprofit that works on reducing deaths in surgery globally.
He has written extensively on medicine and public health for The New Yorker and Slate, and is the author of the books Complications, Better, The Checklist Manifesto, and Being Mortal.