Go back to the '30s, '40s, '50s, and it was the discovery of heroic interventions, the ability to cure people with penicillin or do an operation to stop disease that was what saved the day. Primary care physicians couldn't do all that much that really demonstrated a difference. The people who control and work with you to control your blood pressure, they're not rewarded for doing that or to be innovative about doing that. So, the result is half of Americans have uncontrolled high blood pressure, despite seeing clinicians.
Atul GawandeNo matter what measures are taken, doctors will sometimes falter, and it isn't reasonable to ask that we achieve perfection. What is reasonable is to ask that we never cease to aim for it.
Atul GawandeThis was not guilt: guilt is what you feel when you have done something wrong. What I felt was shame: I was what was wrong.
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 Gawande