Better: A Surgeon’s Notes on Performance
Gawande examines why some doctors perform better than others, not by a little, but by a significant amount.
This is important. Being a lot better is the ability to save patients’ lives or not. The stakes are high.
The lessons he draws apply to other professions, including lobbyists.
If a lobbyist makes a mistake, their client’s economic well-being may be compromised, and their interests may be harmed.
The post below is some of the extracts that I found useful.
What does it take to be good at something
He mentions those attributes of the athlete: Perseverance, Hard work and Practice. He notes the need to (1) Master a vast set of knowledge and realise it is incomplete, (2)Act with swiftness and consistency, (3)Marshal a team of many people, (4) that team had to be meticulous about every step.
He stresses:
First, diligence. Give sufficient attention to detail to avoid errors and overcome obstacles.
Second, is to do right.
Third, ingenuity. It demands more than anything, a willingness to endeavour to recognise failure, to not paper over the cracks, and to change. It arises from deliberate, even obsessive, reflection on failure and a constant searching for new solutions.
How should you be paid
Doctors in the USA are paid on a formula created by Professor William Hsiao.
The formula is: time, mental effort and judgment, technical skill and physical effort, and psychological stress.
Some doctors are paid more than others.
And, some doctors, who step out of the insurance system, get paid a lot more. They are the stars who can do things others can’t.
The advice for doctors on how to achieve commercial success is useful.: Physicians must computerize their billing systems. Carefully review the bills they send out and the payments that insurers send back. They must hire office personnel to deal with the insurance companies.
Use a simple checklist
A newborn baby goes through the Apgar Test. It has saved the lives of many.
What would the Apgar test look like in lobbying? Do you have evidence, a solution, allies in key member states, the European Parliament (EP), and the European Commission? Are you in time to influence the process?
Realise there is a Bell Curve
Some doctors have better results than others. Not a little better, but a lot better. There is an elite who have 10 times better results than their counterparts.
To get outstanding improvements seems to require:
1. Measure our results and be more open about what we are doing.
2. Focus
3. Aggressiveness
4. Inventiveness
5. Weekly joint review of patients
6. Uniform treatment protocols
Gawande contends that the science of performance – from washing hands, to fast treatment in battle etc – has saved many lives, and “the scientific effort to improve performance in the medicine, an effort that at present gets only a minuscule proportion of scientific budgets, can arguably save more lives the next decade than the bench science, more lives than research on the genome, stem cell therapy, ccancers, vaccines and all other laboratory work we can hear about in use.”
How to Make a Positive Difference
1. Ask an unscripted question
2. Don’t complain.
3. Count something. Track what you are doing to see if it works.
4. Write something. He notes that the invention of a mechanism for the systematic publication of fragments of scientific work may well have been the key event in the history of modern science”.
… So choose your audience. Write something.
5. Change. Become an early adopter.