Pit crews and not cowboys needed in hospitals  JUN 01 2011

In his recent commencement address at Harvard Medical School, Atul Gawande argued that medical practitioners need to shift from thinking of themselves as cowboys to thinking of themselves as pit crews.

Two million patients pick up infections in American hospitals, most because someone didn't follow basic antiseptic precautions. Forty per cent of coronary-disease patients and sixty per cent of asthma patients receive incomplete or inappropriate care. And half of major surgical complications are avoidable with existing knowledge. It's like no one's in charge-because no one is. The public's experience is that we have amazing clinicians and technologies but little consistent sense that they come together to provide an actual system of care, from start to finish, for people. We train, hire, and pay doctors to be cowboys. But it's pit crews people need.

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