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Exposes Medicines Own Diseases 
What can medicine do to improve the quality of patient care around the world? That is, at its heart, the question that author Atul Gawande throws at readers and practitioners alike. "We can do better," he tells us, and thus begat the title: BETTER.
Having thoroughly enjoyed Complications, I decided to check out Dr. Gawande's other writings and was pleasantly surprised to find this collection of stories. Although both Complications and Better are short story compilations, Complications lacked cohesiveness whereas Better had no such problems.
Leading us down simple and often shocking paths, Gawande gives us complicated facts but in laymen's terms. The simplest would be his chapter on hand washing, and how effective it can be for preventing the spread of infection, especially such newly dangerous things as MRSA, an antibiotic resistant bacterial strain that is killing hospital patients far too often. The ease with which its spread is preventable is as simple as a hand cleanser, yet getting doctors (and other medical staff) to do this is nearly impossible. "We can do better."
The beleaguered medical malpractice insurance requirements that plague every doctors pocketbook is hit hard upon, including a look at why it is necessary and why the system is headed for deep trouble. "We can do better."
Probably the most telling chapters were directed at Dr. Gawande's return to India (his national homeland). Polio is on the run and is nearly extinct as a disease. Yet in small Indian provinces, occasional "hot spots" flare up and a band of less than 10 medical men and women must vaccinate over 4 million children in less than two weeks. And they do it. Gawande tells us if this is possible, can't the U.S. do better at fighting infection? The other striking aspect is how India's doctors often work with substandard supplies (or minimal) on dangerous cases. Or perform a surgery they've never done before or are ill equipped to handle. But handle it they do. One such case involved a boy with hydrocephalus ("water on the brain" caused by a build up of cerebral spinal fluid). No physicians at the hospital Gawande visited had ever done a shunt, the procedure necessary to relieve the pressure. But they eventually do a makeshift surgery that saves the boys life "using about as few supplies as I'd use for a suture repair." Quite an eye-opener. "We can do better."
The chapters on CF (cystic fibrosis) are exceptionally well rendered as we learn that doing better at one thing can have huge benefits. When physicians focus all of their talents on cystic fibrosis, the result was astounding. Life expectancy for CF patients jumped from 17 years of age to over 40. And now it looks like they may very well be able to live into the 70s. It isn't some new super-drug that's extending these peoples lives, but looking at the disease process in terms of better treatment strategies; living proof that doing "Better" can help medicine achieve miraculous results.
Atul Gawande is to be commended for writing a book that flays open the medical system and exposes the diseases beneath; diseases that we can do better at.
Highly Accessible Essays on Medical Care Today
Atul Gawande's talent for bringing complex issues before the general public lies in his excellent writing ability, apparent in his earlier work, "Complications." He explores the issues of current medicine in penetrating essays that can be grouped into three categories: Diligence, Doing Right, and Ingenuity. Doctors in the United States today are facing a litigious public that demands perfection from mere mortals. Gawande presents a balanced picture from the view of patients and their families as well as from doctors' perspectives. The economy of his writing permits the reader to zero in on the issues quickly. I must say, right from the outset of this collection, that the essay on hand washing has made me leery about any doctor's touch. Today's headlines about incurable bacterial infections now reaching into our school systems bear out the relevance of Gawande's concerns.
I see no sense in rehashing all the essays here. As a reader, you should know that these essays are highly relevant to all of us and underscore what we don't know about our healthcare. When we enter a facility for treatment, for instance, do we know where that facility stands in relation to positive outcomes for the condition we need treated? If not, why not? I did especially like the essay about medicine in India, as I frequently visit there on business. I think Gawande's thoughts about achieving better results through diligent adherence to what we already know works is good advice for many areas in life, not just medicine.
This collection is well worth anyone's time. It's thoughtful, well written, and relevant to all of us.
A fun, thought-provoking read
A fascinating book, with great stories on a timely subject. I especially liked the chapters on Diligence. I tend to agree with Gawande that if the U.S. health system concentrated less on new drugs and fancy treatments, and more on good patient management and careful followup, we'd all be better off.
Gawande suggests that we scrap the present malpractice system entirely. He points out that under the present system a tiny number of patients harmed by doctors receive huge amounts of money, while the vast majority of victims get nothing. Gawande suggests a system in which people who are harmed by doctor error receive a set, limited compensation, without regard to who is at fault, negligence, and the like. This system is already in use in New Zealand. I think Gawande's is the best approach I have seen to the present malpractice mess.
Another readable book 
I read his first book, "Complications", and loved it. "Better" is great follow-up. It's an easy read for even the most non-scientific among us. I work in business, and understand little about science or medicine, but I found this to be a supreme read.
better...should have been Better 
Disappointing outing for this usually wonderful author.Granted he does not try to hide from the blemishes of the surgical world but the book at times went on and on and became boring.
I do believe that he is a brave man to write the types of books and articles
that he does write, as the medical profession is a closed society.I understand his need to try to make medicine better but is this the way to do it? we'll never really know.
reviews: 1, 2, 3, 4, 5, 6, 7, 8, page 9, 10, 11, 12, 13, 14, 15, 16, 17
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based on 81 reviews
