People underestimate the importance of dilligence as a virtue. No doubt it has something to do with how supremely mundane it seems. It is defined as "the constant and earnest effort to accomplish what is undertaken."... Understood, however, as the prerequisite of great accomplishment, diligence stands as one of the most difficult challenges facing any group of people who take on tasks of risk and consequence. It sets a high, seemingly impossible, expectation for performance and human behavior.

Culture matters. Of course, if physicians are rewarded or penalized for their service and results, the culture will change. But the key values we doctors are being pressed to embrace are humility, teamwork, and discipline.

Just 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.

This is the reality of intensive care: at any point, we are as apt to harm as we are to heal.

I chose surgery because I thought that perhaps this would make me more like the kind of person I wanted to be.

Human interaction is the key force in overcoming resistance and speeding change.

Better is possible. It does not take genius. It takes diligence. It takes moral clarity. It takes ingenuity. And above all, it takes a willingness to try.