Better
A Surgeon’s Notes on Performance
Atul Gawande
Being better is a funny thing. We all want to do the best we can. We can even become devastated if we learn or feel that we aren’t. And yet, is there really an end point to this goal? Doesn’t everyone have room for improvement? But to improve we have to identify, acknowledge and address flaws. Tricky business, in’t it?
As Dr. Gawande writes, “Betterment is a perpetual labor….. To complicate matters, we in medicine are also only humans ourselves. We are distractible, weak, and given to our own concerns…. The question… is not whether one accepts the responsibility. Just by doing this work, one has. The question is, having accepted the responsibility, how one does such work well.”
Dr. Gawande explores what he considers three core components for success, in medicine, in risk and responsibility: diligence, doing right, and ingenuity.
Before we dig in, let’s revisit the concept of a bell-curve. Most results follow a bell-curve. Most of our results and outcomes are probably average, and fall in the center of the bell curve. If you want to be better, you’ll compare your results to the bell-curve, by comparing our successes and failures to our peers, within our hospital or within the literature.
Diligence
Steady, earnest and energetic effort; persevering application. (Merriam Webster Dictionary) In other words, hard work, probably boring, and really easy to avoid. Pursue the concept of positive deviance- in other words, strive for the right of the bell-curve. As you try to move within the bell-curve, the smallest changes and habits will make the greatest differences.
Acknowledge the problem, investigate the underlying causes (including asking those within the problem where they see contributions), and take action, consistently, persistently and patiently.
Doing Right
Ethics are not always clear. There are many grey areas. There will be struggles, personally, professionally and amongst your profession. You may have to choose between the law, the practice, and your morals. Doing what everyone else does, if unethical, is not going to produce “better”. Do the hard thing. Do the right thing.
Ingenuity
Ingenuity involves diligence in tracking the problems/weaknesses/errors, but also proactively taking measures to push up the bell-curve, not just accepting standard of care. A responsibility to ingenuity also involves the advancement of medicine overall. This necessitates being open about what we are doing. The Mayo brothers established one of the most advanced and sought after clinical practices in the countryside of remote Minnesota, in part, because of these practices. They openly accepted colleagues to observe them, and took every advantage to do likewise. They managed to advance medicine worldwide by example and ingenuity. (The Doctors Mayo, Helen Clapesattle)
The Mayo Clinic has led innovative health care through very unique ingenuity.
Dr. Gawande manages to challenge while inspiring, using medical examples and scenarios. This is most definitely worth the read, and is very readable. While the call to betterment is not an easy one, he outlines how impactful small actions can be in our profession and practice.
So, where do you want to be Better? How can you apply these tactics to do so? And how are you going to manage the hit to your ego, or prevent letting your imposter syndrome from even starting?!
Further Reading/Resources:
For Better Or Worse
Book Rounds: Imposter Syndrome
Book Rounds: Feedback
Thanks , I have recently been searching for info about this topic for ages and yours is the best I’ve found out till now. But, what concerning the bottom line? Are you sure about the source?
Wow! Thank you! I constantly wanted to write on my site something like that. Can I take a portion of your post to my website?
I would like to thnkx for the efforts you’ve put in writing this website. I’m hoping the same high-grade website post from you in the upcoming as well. Actually your creative writing abilities has encouraged me to get my own web site now. Really the blogging is spreading its wings quickly. Your write up is a great example of it.
My husband and i felt now lucky that Raymond could round up his research out of the ideas he came across using your web site. It’s not at all simplistic just to choose to be giving freely strategies people today may have been making money from. And we also figure out we’ve got you to be grateful to for that. All of the explanations you made, the easy web site menu, the relationships you help instill – it’s most sensational, and it’s really letting our son in addition to us believe that that situation is pleasurable, and that’s extremely important. Thanks for everything!
hey there and thank you for your info – I have definitely picked up anything new from right here. I did however expertise a few technical issues using this website, as I experienced to reload the web site lots of times previous to I could get it to load correctly. I had been wondering if your web host is OK? Not that I am complaining, but slow loading instances times will very frequently affect your placement in google and could damage your high quality score if ads and marketing with Adwords. Anyway I’m adding this RSS to my email and could look out for a lot more of your respective interesting content. Ensure that you update this again soon..
Good web site! I really love how it is simple on my eyes and the data are well written. I’m wondering how I could be notified when a new post has been made. I have subscribed to your feed which must do the trick! Have a nice day!
I am constantly searching online for ideas that can facilitate me. Thanks!
I¡¦m not positive where you are getting your information, however good topic. I needs to spend some time learning much more or working out more. Thanks for excellent info I used to be searching for this information for my mission.
hey there and thank you for your info – I have definitely picked up anything new from right here. I did however expertise a few technical issues using this website, as I experienced to reload the web site lots of times previous to I could get it to load correctly. I had been wondering if your web host is OK? Not that I am complaining, but slow loading instances times will very frequently affect your placement in google and could damage your high quality score if ads and marketing with Adwords. Anyway I’m adding this RSS to my email and could look out for a lot more of your respective interesting content. Ensure that you update this again soon..
Great weblog right here! Additionally your web site a lot up fast! What host are you the usage of? Can I get your associate link in your host? I desire my site loaded up as fast as yours lol
I get pleasure from, result in I found just what I used to be taking a look for. You have ended my four day lengthy hunt! God Bless you man. Have a great day. Bye
Hello, i think that i saw you visited my blog thus i came to “return the favor”.I’m attempting to find things to enhance my website!I suppose its ok to use some of your ideas!!
As I web-site possessor I believe the content matter here is rattling fantastic , appreciate it for your hard work. You should keep it up forever! Best of luck.
My husband and i felt now lucky that Raymond could round up his research out of the ideas he came across using your web site. It’s not at all simplistic just to choose to be giving freely strategies people today may have been making money from. And we also figure out we’ve got you to be grateful to for that. All of the explanations you made, the easy web site menu, the relationships you help instill – it’s most sensational, and it’s really letting our son in addition to us believe that that situation is pleasurable, and that’s extremely important. Thanks for everything!
It’s actually a cool and helpful piece of info. I am satisfied that
you shared this useful information with us. Please stay us up to date like this.
Thanks for sharing.
Hi, Neat post. There is an issue with your website in web explorer, would test this¡K IE still is the market chief and a huge element of folks will pass over your great writing due to this problem.
Great tremendous things here. I’m very glad to look your article. Thank you so much and i am taking a look ahead to contact you. Will you please drop me a mail?
I was recommended this website by my cousin. I’m not sure whether this post is written by him as nobody else know such detailed about my trouble. You are incredible! Thanks!
It¡¦s really a great and helpful piece of information. I¡¦m satisfied that you shared this helpful information with us. Please keep us informed like this. Thank you for sharing.
Good ¡V I should certainly pronounce, impressed with your website. I had no trouble navigating through all the tabs as well as related information ended up being truly simple to do to access. I recently found what I hoped for before you know it in the least. Quite unusual. Is likely to appreciate it for those who add forums or anything, website theme . a tones way for your customer to communicate. Excellent task..