There's a new article today on Salon titled: Healthcare Reform Rock Star, featuring one of our favorite authors, Atul Gawande. Gawande is a staff writer for the New Yorker and author of The Checklist Manifesto: How to Get Things Right, and Better: A Surgeon's Notes on Performance, books we copiously recommended. And his first book, Complications, garnered rave reviews.
So why in the world would you write a book about checklists, of all things? What we're grappling with in reform or public health is immense complexity. We do 50 million operations a year in the U.S., with 150,000 deaths within 30 days. Five hundred thousand people are disabled, and half of those are avoidable. When we think about how we grapple with complexity, we've been using two solutions: super-specialization and technology. These haven't been good enough. When I looked at how other worlds like aviation and construction grapple with complexity, I found checklists. But checklists are also an admission of fallibility. It's an admission that individuals aren't the only thing that matter, that chains of people and processes matter. Further, it's an admission that we can't handle the complexity that's coming at us. And I think that's the case across lots of walks of life.And it is the case. While it may seem like rote advice: life is complex; use checklist, Gawande is getting to something more important here which is evident in his statement that "checklists are also an admission of fallibility." Whether it is due to feelings of responsibility or hubris, we often think we can handle more than we can, to the detriment of the people around us. Gawande does something similar in his book, Better, addressing "how doctors strive to close the gap between best intentions and best performance in the face of obstacles that sometimes seem insurmountable." We may all set out to excel at our chosen professions, endeavor to do our best every day, but when lives (or our businesses or our families) are on the line, how do we actually match the work to those intentions? At the end of the Salon article, Gawande is asked what he would like to be remembered as having accomplished. As a relatively young surgeon, and with a lot more to say no doubt about medicine and work, Gawande said, "I don't know. My teams once asked me what our mission statement is. All I could come up with is to do cool stuff that lasts. That's all I got." That too is a motto that transcends any field. *** Read our Jack Covert Selects on The Checklist Manifesto here. Read our review of Better, which was included in the "lost" The 100 Best Business Books of All Time chapter on Industry books which can be downloaded here.