Overview: Charles J. Yeo, MD

Summer reading!

Mixed amongst the thrillers that I read this summer, two important nonfiction works held my attention. Both focused on a topic of interest to all of us – improvement of the U.S. health care “system”.

First, former Senate majority leader Tom Daschle, in his short book Critical: What We Can Do About The Health-Care Crisis gives us an abbreviated history of past health care reform in America, cautiously uses patients’ sad stories to depict the current crisis, nicely portrays the complexities of our “system”, and proposes a solution which is analogous to the Federal Reserve Board (which oversees our very complicated financial system). Daschle’s thesis is that a Fed-like Health Board would insulate our health care delivery system from political pressure, insure that experts review policy and share accountability, and could lead to an improved standard of care for our patients, at a lower cost.

Second, best selling author and surgeon Atul Gawande, in his book The Checklist Manifesto: How To Get Things Right nicely shows just how complex the care of our patients has become with modern medicine. He argues that the era of the Middle Ages’ “master builder” has necessarily ended, as current day management of patients exceeds the ability of even the most talented clinician to provide all encompassing care. Using lessons from the airline and space industries, Gawande shows how the implementation of specific, focused checklists have yielded remarkable success – decreasing the incidence of central line infections, improving ICU care, and in the operating room: reducing errors, wrong-site surgery, retained foreign bodies and overall mortality rates.

Both of these books are concise and quick reads. In my mind, both are required reading for physicians whose ultimate goal is to improve the care delivered to our patients.