In his book Better, Dr. Atul Gawande explores how doctors can provide better care for their patients. He discusses the importance of communication and collaboration between physicians and patients, as well as the need for continued education and training for doctors. He also highlights various case studies in which improved care has led to better outcomes for patients. Ultimately, Gawande argues that by working together, doctors and patients can make a real difference in the quality of care that is available.
Mr. Gawande begins his essay on hand hygiene with a reference to the work of Dr. Semmelweis. Two friends, a microbiologist and an infectious disease specialist, are introduced. Both fight hard and diligently against the spread of illnesses, just like Semmelweis, who is mentioned in the chapter. Something I learned that few people are aware of is that each year 2 million individuals become infected while they are in hospital because doctors wash their hands only one-third to one-half as many times as they should.
There are several reasons for this among them, the number of patients that need to be seen, lack of time and too much-unnecessary paperwork.
In the chapter “The Checklist”, Mr. Gawande tells us about his experience in McAllen, Texas. He was asked to help out with the problem of overspending on health care. What he found was that the town had more than twice as many MRIs than El Paso, though their populations were similar in size and demographics. They also had plenty of other tests and procedures being performed that were not needed. When he met with the doctors to discuss this issue, they were very defensive and uncooperative.
Mr. Gawande goes on to talk about the need for checklists in various aspects of our lives. He gives several examples, such as when landing an airplane or performing surgery. He also talks about the importance of having a “time-out” before starting a procedure, to make sure everyone is on the same page and knows what needs to be done.
In the chapter “Safe Surgery”, Mr. Gawande tells us about the work of Doctor Peter Pronovost. Doctor Pronovost is trying to reduce the number of deaths due to hospital acquired infections. One of the main ways he does this is by making sure that surgeons wash their hands and use sterile equipment. He has also developed a checklist for surgeries, which has helped to reduce the number of complications and deaths.
Doctor Pronovost’s work has shown that it is possible to reduce the number of hospital acquired infections. However, it is not easy to get doctors to change their habits. Many of them are resistant to change and do not want to be seen as making mistakes.
In the chapter “The Cost Conundrum”, Mr. Gawande talks about the difference in costs between different hospitals. He gives the example of two hospitals in Texas, one of which charges twice as much as the other for the same procedures. The reason for this is that the more expensive hospital has more staff and equipment, which leads to higher costs.
However, studies have shown that there is no correlation between cost and quality of care. In fact, the more expensive hospital is no better at treating patients than the less expensive one. The only difference is that the more expensive hospital is able to charge more for its services.
Mr. Gawande concludes his book with a call for reform in the healthcare system. He talks about the need for transparency in pricing, so that patients can make informed decisions about their care. He also talks about the need for doctors to be more open to change and to listen to their patients.
Overall, I found this book to be very insightful. It was eye-opening to learn about some of the issues in the healthcare system. I would recommend it to anyone who is interested in learning more about the healthcare system and how it can be improved.
The Austrian physician Ignaz Philipp Semmelweis, mentioned previously, revealed in 1847 that medical professionals were to blame for childbed fever, which was the most common cause of maternal death during childbirth. The latest sanitizing gels are apparently the finest solutions; they’ve only recently started being used in the United States. Then there was an attempt to make sanitization easier for everyone. Perreiah developed techniques that allowed staff more time, which was remarkable in itself, but they only worked when he kept track of them.
The next step was to generalize the system so that it would work without him. The principles Perreiah used were those of a scientific method: first, he formulated a hypothesis about what might be causing the problem; second, he designed a test to see if his hunch was correct; and third, he analyzed the results to see what they revealed. These same principles can be applied to any problem, large or small.
It is often said that in order to improve we must first identify what needs improvement. But this is not always easy, because we are often too close to the problem to see it clearly. We may also be reluctant to acknowledge that there is a problem in the first place. And even if we do recognize that there is a problem, we may not know how to go about solving it.
Gawande tells the story of Donald Berwick, who was asked by President Obama to lead the Centers for Medicare and Medicaid Services (CMS). One of Berwick’s first tasks was to find ways to reduce the rate of hospital-acquired infections, which were responsible for tens of thousands of deaths each year.
Berwick realized that the key to reducing infection rates was to standardize best practices throughout the healthcare system. He instituted a program called “Checklist for Change,” which required all hospitals that participate in Medicare and Medicaid to use a checklist for certain high-risk procedures, such as inserting catheters or intubating patients.
The results of the program were impressive: in just one year, the rate of hospital-acquired infections dropped by more than 18 percent. This saved thousands of lives and millions of dollars.
Gawande concludes with a discussion of the importance of humility in medicine. He argues that we cannot expect perfection from ourselves or from others, but we can always strive to do better.
In order to do this, we need to create a culture of safety in which errors are recognized and addressed, rather than hidden or denied. We also need to give people the tools and resources they need to improve. And finally, we need to instill a sense of shared purpose among those who work in the healthcare system.
If we can do these things, then we will start to see real progress in the quality of care that patients receive. And that, ultimately, is what matters most.