I just finished reading Atul Gawande’s Better.  In case what I write below doesn’t come across strong enough, let me say now that I believe this book should be required reading at all hospitals (human and veterinary) and among all personnel.

A fantastic and quick read, it is a compilation of 12 original and previously published essays adapted from the New England Journal of Medicine and the New Yorker.  If you are unfamiliar with his writing and personal story, you’re in for a real treat.  From issues of medical ethics to battlefield medicine to the remarkable power of hand washing, his book seeks to (and will) inspire you to improve not only the way medicine is practiced, but your outlook on life.

Perhaps the greatest takeaway is an understanding of how important it is to  establish performance as a science.  Gawande writes, “Indeed, the scientific effort to improve performance in medicine -- an effort that at present gets only a miniscule portion of scientific budgets -- can arguably save more lives in the next decade than bench science, more lives than research on the genome, stem cell therapy, cancer vaccines, and all the other laboratory work we hear about in the news.”

The best part of this view?  It is something that each and every one of us has control over.  It’s not dependent on budgets, Congressional approval, think tanks, etc.

We can must make our own individual commitment to improving performance in medicine.  As I wrote in a previous post, the basis for making performance innovations is in becoming and rewarding positive deviants.  Here are Gawande’s suggestions for how to do this in the medical environment:

1. 1.Ask an unscripted question.  Take a moment with you clients and patients.  Ditto for those you work with.  Ask them something about themselves -- where they grew up, what made them move here, did they watch last night’s game -- anything.  Just make a human connection.  Not only may this clue you into some important, if not humanizing information, it will help you realize that you are not simply part of a machine but are connected to the lives of other individuals.
   

2. 2.Don’t complain.  Even though doctors have a lot to complain about, that kind of conversation is uninspiring and will bring you and your colleagues down.  Be prepared with something else to discuss -- an idea you read about, an interesting case, etc.
   

3. 3.Count something.  You should be a scientist of the world.  You could count complication rates, particular ailments, even certain breed types.  The only thing that matters is that what you are counting should be interesting to you.  If you count something you find interesting, you will learn something interesting.
   

4. 4.Write something.  Doesn’t matter how long or sophisticated.  Write for a blog, a newsletter, a journal, even a poem for a reading group.  Writing about what you observe in the world is an important way to contribute to our collective know-how.
   

5. 5.Be an early adopter.  Look for opportunities to change.  This doesn’t mean embracing every new trend, but having a willingness to seek out solutions to the problems around you.  While it may be safer to do what everyone else is doing, no great advances will come from that sort of behavior.
   

“Better is possible.  It does not take genius.  It takes diligence.  It takes moral clarity.  It takes ingenuity.  And above all, it takes a willingness to try.” -- Atul Gawande