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Better: A Surgeon's Notes on Performance (original 2007; edition 2008)

by Atul Gawande

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1,486545,001 (4.03)54
Member:darkeyes3302
Title:Better: A Surgeon's Notes on Performance
Authors:Atul Gawande
Info:Picador (2008), Edition: 1st, Paperback, 288 pages
Collections:Your library
Rating:****
Tags:read, 2012, audiobook, medicine

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Better by Atul Gawande (2007)

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English (53)  Italian (1)  English (54)
Showing 1-5 of 53 (next | show all)
I enjoyed Better almost as much as I did [Being Mortal]. In this book, Gawande discusses what it is that make some doctors and some hospital programs better than others. Why hand washing--so important in halting the spread of MRSA--is so difficult to convince staff to do--even doctors! He discusses the upward trend of C-sections and the disuse of forceps in childbearing. Plus, as they say, so much more!

I especially like his five steps to making the practice of medicine--of anything, really--more rewarding. I'll add a zeroeth one right now (for Asimov fans):
0. Read the book
1. Ask an "unscripted" question. Talking to the grocery clerk? Ask a non-grocery related question. See them as a person, not just a clerk.
2. Don't complain. We can all gripe about something, but it tends to feed on itself. And all it accomplishes is to drag you down. Change the subject.
3. Count something. Find something you are interested in and become an expert in it.
4. Write something everyday. A paper to be published. A poem. A blog. A letter to your older sister.
5. Change. Become an early adopter. Exchange that old flip phone for a smart one. Upgrade your operating system. Luckily, we no longer have to learn to program the clocks on our VCRs (if you still have one, consider donating it for parts), but think about what has you stumped and waiting for your third grade granddaughter to come visit. ( )
  kaulsu | Oct 17, 2016 |
A great perspective on the varying roles of a doctor. ( )
  LaPhenix | May 17, 2016 |
An excellent sequel to [Complications]. Gawande continues with his thoughtful and thought-provoking essays on the art of medicine. ( )
  BookConcierge | Feb 29, 2016 |
Excellent insider perspective about the difficulties health professionals face in trying to provide care. Gawande takes us from polio outbreaks in India all the way to the endless variations of potential troubles in childbirth for historical and contemporary women. ( )
  andreasaria | Jan 24, 2016 |
First published at Booking in Heels.

The key thing to know about this book is that it's not about how doctors can make their patients better, it's about the ways they can improve to make their own practice and treatment regime better. That said, it's far from a manual aimed at lecturing hospital staff, it's an accessible and engaging collection of thoughts that I would say is aimed at the general public.

Mr Gawande has divided his book into three sections - Diligence, Doing Right and Ingenuity - which he says are the three core requirements for success in medicine, or any endeavour that involves risk and responsibility.

Diligence was perhaps my favourite of the three sections as it focuses more on doctors as people, and the tiny little everyday responsibilities that I find fascinating. It looks at how, despite the movement started in the 1840s to encourage doctors to wash their hands, a surprisingly large amount of them still forget when running from patient to patient. We also examine the huge-scale campaigns to eradicate polio and the effort required to vaccinate every single child in India, and the brave doctors who accompany the military to Iraq, Afghanistan and every other campaign across the globe.

Doing Right looks at the obligations that doctors and other medical professionals are under, and whether they are always strictly fair. For example, there's a chapter on whether it should be obligatory for a doctor to attend during a state execution or whether this directly contravenes their purpose, which is to heal people. I also really enjoyed the chapter about how doctors examine the more intimate areas of a person's body and whether a chaperone should be required.

Lastly, we look at Ingenuity, which covers the introduction of the Apgar score (which assesses the health of a newborn baby) as well as looking at how medical centers and hospitals and can improve by comparing the statistics of other, similar centers.

However, the topics almost fall into irrelevance when compared to Mr Gawande's prose. He writes with such humanity and grace that you'd be forgiven for thinking he was an author by trade, not a surgeon. I was also impressed by his seeming complete lack of bias. There's a chapter on medical malpractice lawsuits which was angering me more and more as I read on (as a disclaimer, I defend doctors from lawsuits for a living!) but he maintains a perfect tone throughout that accepts that doctors are people too. Mistakes are made, some are unavoidable whilst some are not, but perhaps patients do deserve some compensation when an avoidable mistake is made.

I'm unsure which of the two books, Complications or Better, I prefer. The topics are slightly different but naturally there is some overlap. Complications focuses more on surgical procedures but therefore involves more case studies, which doesn't really interest me because I do nothing but nosy at other people's illnesses at work. I can see how that might interest people not quite as pompous as myself, however.

Better doesn't feature any case studies and the sections on execution chambers and eradicating polio (amongst others) were fascinating. However, there are a few chapters on the cost of treatments, statistics and medical hierarchy that just weren't applicable to countries other than America. I ended up skipping the section on funding because it made so little sense to me. It's written just as well as the remainder of the book, but it just didn't appeal to me as a UK resident.

To solve the comparison problem, I'd honestly just read both of them. And also Being Mortal: Illness, Medicine and What Matters in the End. I haven't read it yet, but I don't see it being anything less than amazing if his previous books are anything to go by. My one complaint about these series is that the silver leaf around the edges of the book does tend to rub off, which looks quite scruffy 280 pages later. ( )
  generalkala | Jan 24, 2016 |
Showing 1-5 of 53 (next | show all)
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For my parents and sister
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Several years ago, in my final year of medical school, I took care of a patient who has stuck in my mind.
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Amazon.com Product Description (ISBN 0312427654, Paperback)

National Bestseller
 

The struggle to perform well is universal: each of us faces fatigue, limited resources, and imperfect abilities in whatever we do. But nowhere is this drive to do better more important than in medicine, where lives may be on the line with any decision.

 

Atul Gawande, the New York Times bestselling author of Complications, examines, in riveting accounts of medical failure and triumph, how success is achieved in this complex and risk-filled profession. At once unflinching and compassionate, Better is an exhilarating journey, narrated by "arguably the best nonfiction doctor-writer around" (Salon.com).

(retrieved from Amazon Thu, 12 Mar 2015 18:11:01 -0400)

(see all 4 descriptions)

Explores the efforts of physicians to close the gap between best intentions and best performance in the face of insurmountable obstacles, discussing such topics as the ethical considerations of lethal injections, malpractice, and surgical errors.

(summary from another edition)

» see all 4 descriptions

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