When We, Doctors, Ask Patients What Their

As Economists Have Often Pointed Out, We Pay Doctors For Quantity, Not Quality. As They Point Out Less Often, We Also Pay Them As Individuals, Rather Than As Members Of A Team Working Together For Their Patients. Both Practices Have Made For Serious Problems.

Good Checklists, On The Other Hand Are Precise. They Are Efficient, To The Point, And Easy To Use Even In The Most Difficult Situations. They Do Not Try To Spell Out Everything--a Checklist Cannot Fly A Plane. Instead, They Provide Reminders Of Only The Most Critical And Important Steps--the Ones That Even The Highly Skilled Professional Using Them Could Miss. Good Checklists Are, Above All, Practical.

Just Look At The List Of Who The Lowest-paid People Are. Pediatricians Are At The Bottom. You Would Also Look At Internists. You Would Look At Psychiatrists. You Would Look At Family Physicians, Hiv Specialists. People Who Take Care Of Chronic Illnesses By Seeing People Carefully Over Time, Those Are The People Who Get The Least Money. The People Who Have The Most Are People Like Orthopedic Surgeons, Interventional Cardiologists. And My Point Isn't That There Is Something Wrong With Heroism.

Man Is Fallible, But Maybe Men Are Less So.

After Readinf Some Essay On The Nature Of Human Fallibility, I Was Very Aware That We Are The Recipients Of A Huge Amount Of Discovery Over The Last Century. Medicine Exemplifies This. And That Has Transitioned Us From A World In Which People's Lives Were Mostly Governed By Ignorance To One That's Constrained By Ineptitude. A Century Ago, We Didn't Know, For Instance, What Diseases Afflicted Us, What Their Nature Really Was, Or What To Do About Them. And That Has Changed.