Television shows such as House promote the idea that, to be great, a doctor simply needs to be brilliant.
But surgeon Atul Gawande, who teaches at Harvard Medical School, says medicine today is so complex that even the sharpest doctors can no longer keep everything they need to know in their heads.
As a result, patients don't always get the care they need.
Only about half of heart attack patients, for example, get the best care within the recommended time window, Gawande says. In some cases, providing consistent care can be more important than a new breakthrough. And even after a new discovery, research shows it takes an average of 17 years for that treatment to reach even half of the Americans who could benefit, he says.
"We have focused on having the great doctor or the great drug," says Gawande, author of the new book The Checklist Manifesto (Metropolitan Books, $24.50). "But on your own, with your training and your brain, there will be things that fall through the cracks, where you find you need the help of other people."
That help can come from a checklist, much like one routinely used by pilots before every flight.
In a study published last year in The New England Journal of Medicine, using a "safe-surgery checklist," which Gawande helped develop for the World Health Organization, reduced the number of complications and deaths by more than one-third.
The checklist requires surgical teams to pause at three crucial points before and after surgery, asking questions such as: Is there enough blood on hand in case of severe bleeding? Have antibiotics been administered? What are the anesthesiologist's and nurse's main concerns?
Going over such a checklist, which takes just two minutes, can "get the dumb stuff out of the way" and allow the team to focus on the most demanding tasks, Gawande says. By asking for information from everyone in the operating room, the checklist also can help transform half a dozen specialists -- who may have never worked together before -- into a team, Gawande says.
Not everyone is convinced; only about 20% of hospitals are using WHO's surgery checklist, he says.
Yet Gawande says the checklist saved one of his patients.
During a tricky surgery to remove an adrenal tumor, Gawande says, he accidentally made a tear in a major vein returning blood to the heart. It was "absolutely catastrophic," he says. Yet thanks to the checklist, the team had extra blood and supplies on hand.
Gawande says he trusts the checklist to help protect his loved ones.
When his son needed heart surgery recently, the operating room team "made a big show of using the checklist."
His son's operation was a success, Gawande says: "He did fabulously. He was home the next day."
To see more of USAToday.com, or to subscribe, go to http://www.usatoday.com
Copyright 2009 USA TODAY, a division of Gannett Co. Inc.