Checklists turn out...to be among the basic tools of the quality and productivity revolution in aviation, engineering, construction - in virtually every field combining high risk and complexity. Checklists seem lowly and simplistic, but they help fill in for the gaps in our brains and between our brains.
Atul GawandeWriting lets you step back and think through a problem. Even the angriest rant forces the writer to achieve a degree of thoughtfulness.
Atul GawandeI talked to over two hundred patients and family members about their experiences with aging, serious illnesses, and the big unfixables. But I also spoke with scores of physicians, and especially geriatricians, palliative care doctors, hospice nurses, and nursing home workers. The biggest thing I found was that when these clinicians were at their best, they were recognizing that people had priorities besides merely living longer. The most important and reliable way that we can understand what people's priorities are, besides just living longer, is to simply ask. And we don't ask.
Atul GawandeIn many ways, the effort to study philosophy was my rebellion away from medicine. I'm the son of two Indian immigrant physicians, so the natural path for me would have been to become a doctor. I ended up doing the master's degree at Oxford in politics, philosophy, and economics while already having a seat in medical school. I was keeping that as my escape hatch. But my hope was that I might become a philosopher or something else entirely.
Atul GawandeDonโt let yourself be. Find something new to try, something to change. Count how often it succeeds and how often it doesnโt. Write about it. Ask a patient or a colleague what they think about it. See if you can keep the conversation going.
Atul GawandeWe now have 30 percent, for example, of Medicare patients who are seeing doctors who are rewarded for doing this kind of work, like high blood pressure control. So, the Affordable Care Act has pushed this direction down the road.
Atul GawandeDeveloping a skill is painful, though. It is difficult. And that's part of the satisfaction. You will only find meaning in what you struggle with. What you struggle to get good at next may not seem the exact right thing for you at first. With time and effort, however, you will discover new possibilities in yourself-an ability to solve problems, for instance, or to communicate, or to create beauty.
Atul Gawande