Gawande on Cowboys and Pit Crews

Philip Betbeze, July 19, 2011

Philip Betbeze is attending the American Hospital Association Leadership Summit in San Diego, where Atul Gawande, MD, spoke Monday.

It's hard to underestimate the pull of an Atul Gawande presentation in healthcare these days. The surgeon, writer and teacher has, over a very short amount of time, become a champion for the difficult work of cutting costs and improving quality—not necessarily in that order—in healthcare. That's why I was not surprised at the packed house when he spoke at the 2011 American Hospital Association Leadership Summit in San Diego Monday.

Gawande's message: We are in a battle for the soul of healthcare. Though he didn't say it in so many words, we're probably in a battle for the soul of the American Dream, and whether people realize it or not, that battle will likely be won or lost on whether we, as a nation, are successful in driving down costs and improving quality in healthcare. After all, much of the partisan battle going on in Congress right now over the national debt ceiling has its roots in the unsustainably high costs of healthcare.

"We cannot afford to have healthcare devour our economy," he said.


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Gawande spent a lot of time talking about using checklists in the operating room, which is not surprising, given that his 2009 book, The Checklist Manifesto, deals with the same subject.

In this struggle, he says, it is fortunate that people who have the most expensive care don't necessarily receive the best care. If that weren't true, our only solution to cutting healthcare costs would be rationing.

Philip Betbeze

Philip Betbeze is the senior leadership editor at HealthLeaders Media.

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