Better: A Surgeon's Notes on Performance | 
 enlarge | Author: Atul Gawande
Publisher: Picador
Category: Book
List Price: $14.00
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Avg. Customer Rating:  76 reviews
Sales Rank: 1451
Media: Paperback
Edition: 1
Number Of Items: 1
Pages: 288
Shipping Weight (lbs): 0.5
Dimensions (in): 8.1 x 5.4 x 0.9
ISBN: 0312427654
Dewey Decimal Number: 616
EAN: 9780312427658
ASIN: 0312427654
Publication Date: January 22, 2008
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Product Description
National Bestseller The struggle to perform well is universal: each of us faces fatigue, limited resources, and imperfect abilities in whatever we do. But nowhere is this drive to do better more important than in medicine, where lives may be on the line with any decision. Atul Gawande, the New York Times bestselling author of Complications, examines, in riveting accounts of medical failure and triumph, how success is achieved in this complex and risk-filled profession. At once unflinching and compassionate, Better is an exhilarating journey, narrated by "arguably the best nonfiction doctor-writer around" (Salon.com).
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| Customer Reviews: Read 71 more reviews...
 Appreciate life and do better! July 1, 2008
The title of this book is great. Gawande's notes on performance will provide a lot of information. He writes about malpractice headaches, insurance obstacles, medical resources in the war and how medical teams have helped so many soldiers. He also mentions a physicians role in the death penalty (that there shouldn't be one) and tells the reader a little about the history of executions. He also provides some history of childbirth and history of tools used. I found out about an inspirational woman named Virginia Apgar too by reading this book. The "fighting on" section did make me emotional and I'm so glad I wasn't somewhere public while reading it.
Every bit of the way Gawande provides nice advice for anyone, not just doctors, to do better.
Transparency, diligence - engines of innovation June 29, 2008
Constantly bombarded by the latest headlines in advances of genomics research, new drugs, and ever sophisticated machinery to help save human lives, Atul Gawande's book offers an insightful suggestion: diligence, transparency, and focus on data-driven improvement, on the part of the doctor, may well be the next frontiers if we're looking to transform the healthcare industry.
Science helps, but ingenuity, and diligence of the doctor are often overlooked and underestimated. Having no affiliation to the healthcare industry, this book has definitely brought me to re-evaluate my relationship with my doctor, and gave me a much better understanding of what to look for in the future.
Excellent Book June 21, 2008
I enjoyed Gawande full view on the topics in medicine that he discussed. It gave me a great feel for the field and also left room for the reader to be critical and think of additional ways of how to make the problems within medicine better
 A paean to diligence June 20, 2008
Atul Gawande's second collection of essays from The New Yorker continues in the same style as his debut, Complications. While the book covers such diverse topics as hand-washing practices among hospital caregivers, vaccination efforts in third world countries, physician-patient relationships and etiquette in various international settings, medical personnel participating in state executions, and malpractice law, the overarching theme of the collection is Gawande's view of clinical medicine as both a science and an art.
Not discounting the central importance of scientific research and innovation, Gawande emphasizes that the most common of life-threatening mistakes occur not due to a lack of scientific understanding of a particular problem but rather a lack of diligence in adhering to practices and procedures that are elementary and thus easily forgotten. To the general public the words "modern medicine" are synonymous with expensive machinery and cutting-edge pharmaceutical therapies but the fact is that far more people in the US and around the world die because of iatrogenic drug-resistant pneumonias than high-grade gliomas (which is not a call-to-arms for gifted, savant doctors but a plea for diligence and discipline from every participant in the continuum of care). Of course the virulence of those infections has been increasing recently but that too can be linked to a lack of diligence in treatment -- excessive antibiotic prescription, inadequate antiseptic practices.
Gawande is bothered by the idea that medicine can be such a theater for technological prowess while simultaneously facing a breakdown in logistics that causes a consistent percentage of patients to receive the wrong medication every day. Here he calls for new systems of internal study and review so that performance can one day match our capabilities. If you enjoy Oliver Sacks and other clinical writing, you will appreciate this book.
As good as Gawande's first book. June 18, 2008
Better" is as good as Gawande's first book. Gawande is interested in the improvement of medical practice, and he combines personal experiences and observations with a study of best practices by others. He is obviously comfortable in interviewing both patients and doctors, as well as being brilliant and an entertaining writer.
As it happens, only because his daughter urged him, he got a second opinion on her psoriasis, and it was cleared up with a common antibiotic. I am sure Gawande had researched her problem, so this illustrates the point he makes later that there is a need for more informal write-ups of things which seem to work. My daughter had a similar experience with a different problem. I was surprised to learn that he expects 2% of his surgeries to go wrong: either there will be life threatening bleeding, or collateral damage like harm to a critical nerve, or a wrong diagnosis.
I enjoyed some chapters more than others, but I have no confidence my rankings will correspond to those of other readers. Anyway, I liked most the chapters on the problems in implementing better hand washing; how treatment of Iraq war wounds was dramatically improved; medical malpractice; medical care in India; and, my favorite, the chapter on the bell curve as illustrated by treatment for cystic fibrosis. I think Gawande really has something in suggesting that the U.S. handle inadvertent harm by doctors as it does harm from vaccines. However, like with unemployment insurance, doctors and hospitals should have to pay more into the fund if their history has been bad.
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