Better: A Surgeon’s Notes on Performance
Atul Gawande
A Book Review by Ed Ruggero
The word “accomplished” doesn’t seem quite enough to describe NY Times best-selling author Atul Gawande. He is a surgeon at Brigham and Women’s Hospital in Boston, a graduate of Harvard Medical School and Rhodes Scholar to boot. He is also a regular contributor to The New Yorker magazine, which, for a writer, is the Big League. At a dinner last year I sat next to a physician who’d been Gawande’s professor in medical school and she assured me that, on top of everything else, he is also a nice guy.
In Better, Gawande turns his considerable powers of observation on his own profession, writing about hospitals, doctors, patients, and even a bit about health policy. His skill as a story-teller and his off-beat perspectives and observations are enough to make the book worth reading. But Better offers more to those who must lead change.
Better is about medicine, but it is also about how human beings try to improve organizations and our own individual performance. The author looks closely at those very human things that keep us from doing what we know we should do, from habit, laziness and simple mistakes to maliciousness.
Gawande covers three significant ideas in the book that are topics for a leader’s attention: Diligence, Doing Right, and Ingenuity. Diligence means “giving sufficient attention to detail to avoid error and prevail against obstacles.” In Doing Right, Gawande discusses “how much doctors should be paid, and what we owe patients when we make mistakes.” Ingenuity “demands . . . a willingness to recognize failure.” More than that, Gawande says that medical professionals—and in my reading, leaders—must practice a “deliberate, even obsessive, reflection on failure and a constant searching for new solutions.”
Gawande also cautions us against infatuation with all things new. Instead of slavishly pursuing the next new thing, making incremental change at great expense, we can often help an organization make bigger strides by doing better what we already know how to do.
“Betterment is a perpetual labor,” Gawande writes, and “the world is chaotic, disorganized, and vexing . . . .” Nevertheless, there are legions out there trying to improve, and Gawande helps us learn from them. Read this book because it is a crackling good story. Read this book for what it can teach about clear communication. Read it because the problems in medicine Gawande addresses are the same as or have clear parallels in other endeavors, including business.
