It’s truly astonishing how so many individuals in health care juggle a gaggle of demanding roles, especially those that do things well. A description of how Dr. Atul Gawande keeps it all straight in “Harvard Magazine:”
This kind of effortless toggling between tasks helps explain how Gawande can keep so many balls in the air. Certain other habits also contribute. He arrives precisely on time—not late, but not early either. He leaves swiftly when meetings end, as others linger to chat. There is nary an idle moment in his day. He saves his writing for the hours between 7 and 11 a.m. and 4 and 7 p.m. to capitalize on the body’s circadian rhythms. And it helps that he isn’t bothered by a lack of downtime.
That’s the disaster of our system, when you have medicine become a business rather than something about what the patient’s needs are.
Oh, and this from an interview with Ezra Klein. Current reform efforts are focusing on insurance reform which, to borrow from the quality improvement vocabulary, is not the root cause of rising costs. Here’s what Dr. Gawande says about that:
I had a hard time connecting the dots. My vantage point on the world is the operating room where I see my patients. And trying to think about whether a public option would change anything didn’t connect. I order more than $50,000 worth of health care in a day. Would a public or private option change that?
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. We’re hoping that Medicare versus Aetna will be more effective at making me do my operations differently? I don’t get that. Neither one has been very effective thus far.