For his part, Atul Gawande clicked off a number of industries were the chauffeur still exists, such as teaching, firefighting, and police work, and yet progress is made. For Gawande the range of costs in healthcare is key. "We know that the most expensive services don't always yield the best results. If it was just a matter of the highest price providing the best care then we would be having a rationing conversation. We know that facilities that have systematic care environments where treatments and services joined together consistently have the best clinical results."
He contends that penicillin, for all its positive attributes, fooled the healthcare industry and consumers into thinking that there would always be easy fixes. "A simple injection that saved thousands of lives. It made us think that the future of medical innovation was going to be just like that. But it wasn't. Healthcare is intensely complicated. We can't perform our own knee operations. We're all in the position of having to hire intermediaries or chauffeurs."