After readinf some essay on the nature of human fallibility, I was very aware that we are the recipients of a huge amount of discovery over the last century. Medicine exemplifies this. And that has transitioned us from a world in which people's lives were mostly governed by ignorance to one that's constrained by ineptitude. A century ago, we didn't know, for instance, what diseases afflicted us, what their nature really was, or what to do about them. And that has changed.
Atul GawandeJust look at the list of who the lowest-paid people are. Pediatricians are at the bottom. You would also look at internists. You would look at psychiatrists. You would look at family physicians, HIV specialists. People who take care of chronic illnesses by seeing people carefully over time, those are the people who get the least money. The people who have the most are people like orthopedic surgeons, interventional cardiologists. And my point isn't that there is something wrong with heroism.
Atul GawandeMy biggest fear, that 27 percent of Americans under 65 have an existing health condition that, without the protections of the Affordable Care Act, would mean they would - could be automatically excluded from insurance coverage. Before the ACA, they wouldn't have been able to get insurance coverage on the individual market, you know, if you're a freelancer or if you had a small business or the like.
Atul GawandeNo travel ban or quarantine will seal a country completely. Even if travel could be reduced by eighty per cent-itself a feat-models predict that new transmissions would be delayed only a few weeks. Worse, it would only drive an increase in the number of cases at the source. Health-care workers who have fallen ill would not be able to get out for treatment, and the international health personnel needed to quell the outbreak would no longer be able to go in.
Atul GawandeGood checklists, on the other hand are precise. They are efficient, to the point, and easy to use even in the most difficult situations. They do not try to spell out everything--a checklist cannot fly a plane. Instead, they provide reminders of only the most critical and important steps--the ones that even the highly skilled professional using them could miss. Good checklists are, above all, practical.
Atul Gawande