Gawande highlights this tendency with some very interesting stories about how a few peole in medicine have become and are becoming better in their performance.

And we all end up measuring the wrong things with the wrong things and coming to wrong conclusions about how successful our performance is. The reality is that these flaws in measuring performance are not limited to medical professionals and institutions.Īll of us tend to measure performance individually and collectively this way.

This looks like a good way to measure performance, but it isn’t really because it does not take into account quality (for example, were surgical instruments left in the living that will cause a problem down the road or were sutures not done properly which will lead to an infection in a week or two that could lead to death?) nor does it take into account specific areas in relationship to those being treated that give a more accurate picture of performance. For example, surgeons are measure on a life/death scale (how many people survived the surgery and how many people did not). Second, medical professionals and institutions measure statistics about performance in broad terms on a success/failure scale. The student with the C is at the top of the class, but is still just average. It’s kind of like a student who has a C in a course where everyone else has a D or an F. Therefore, when we compare ourselves with others, we are under the wrong impression that we are either doing as well as or better than others. This is faulty because each of us tends to rate our skill, knowledge, and abilities as much higher than they actually are. Too often, in medicine, performance is measured in two default ways.įirst, medical professionals and institutions measure themselves against each other. When we measure the wrong things with the wrong things, we come up with a wrong analysis of our performance. One of the overarching things that comes out time and again in this book is that while skill, knowledge, and abilities are important, it is how we use (and measure the outcomes) them – performance – that matters most.

While Gawande tackles performance and the medical profession – and does an excellent job of saying “this is how it looks” and “this is what we all need to do” – here, the principles apply to each of us a humans in every aspect of our lives: personally (as individuals and in our relationships), professionally, socially, and spiritually. This book should be on everyone’s must-read list. Gawande is not only a conscientious physician, but he is also a thoughtful leader (who admits his own shortcomings and failures) and an excellent writer, and that combination is always appealing to me. Better: A Surgeon’s Notes on Performance by Atul Gawandeīy Atul Gawande, I added all his books to my to-read list.

A surgeon's notes on performance