Wednesday, June 01, 2011

Gawande on Cowboys and Doctors

Atul Gawande gave a commencement address at Harvard last week, and focused on the subjects he covered so well in his book The Checklist Manifesto. Given the setting, he adds a charge to the graduating class to enact the reforms he argued for. The line in his speech that caught my attention and makes me hopeful that the health care system may be moving in the direction he promotes was this:

Two years ago, the Institute for Healthcare Improvement started its Open School, offering free online courses in systems skills such as outcome measurement, quality improvement, implementation, and leadership. They hoped a few hundred medical students would enroll. Forty-five thousand did. You’ve recognized faster than any of us that the way we train, practice, and innovate has to change.

If the next generation of doctors understands and is buying into the idea that we need more systemic approaches to managing health care, there may be a chance that the system will gradually (or we can at least hope, rapidly) reform into something more sustainable, and directed at effective care.

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