No matter what measures are taken, doctors will sometimes falter, and it isn’t reasonable to ask that we achieve perfection. What is reasonable is to ask that we never cease to aim for it.
Just ticking boxes is not the ultimate goal here. Embracing a culture of teamwork and discipline is. And if we recognised the opportunity, the two-minute WHO checklist is just a start.
Instead they choose to accept their fallibilities. They recognised the simplicity and power of using a checklist.
We are besieged by simple problems…. Checklists can provide protection
All the same I fear what happens when we expand the terrain of medical practice to include actively assisting people with speeding their death. I am less worried about the abuse of these powers than I am about dependence on them.
This was not guilt: guilt is what you feel when you have done something wrong. What I felt was shame: I was what was wrong.
In this work against sickness, we begin not with genetic or cellular interactions, but with human ones. They are what make medicine so complex and fascinating.
Life is choices, and they are relentless. No sooner have you made one choice than another is upon you.
We want progress in medicine to be clear and unequivocal, but of course it rarely is. Every new treatment has gaping unknowns – for both patients and society – and it can be hard to decide what do do about them.
If there is a credo in practical medicine, it is that the important thing is to be sensible.
Are doctors who make mistakes villains? No, because then we all are.
Health care confronts us with a difficult test. We have never corrected failure in something so deeply embedded in people’s lives and in the economy without the pressure of an outright crisis.
Our health-care morass is like the problems of global warming and the national debt – the kind of vast policy failure that is far easier to get into than to get out of. Americans say that they want leaders who will take on these problems.
The history of American agriculture suggests that you can have transformation without a master plan, without knowing all the answers up front.
People say that the most expensive piece of medical equipment is the doctor’s pen. It’s not that we make all the money. It’s that we order all the money.
Oliver Sacks remains my hero to this day. He was one of the first medical writers I read. The other was Lewis Thomas, who is no longer alive but is just heroic to me.
No one teaches you how to think about money in medical school or residency. Yet, from the moment you start practicing, you must think about it. You must consider what is covered for a patient and what is not.
Cost is the spectre haunting health reform. For many decades, the great flaw in the American health-care system was its unconscionable gaps in coverage.