Better is not deep or systematic. It's a collection of vignettes that consider how and when doctors do well and could do better. Gawande wants better outcomes for patients. He's a scientist; he examines evidence. He's a humane and imaginative individual; he tries to get inside of the minds of doctors and patients. He's sympathetic to human beings, whether they are doctors who become embroiled in assisting executions against the rules of medical ethics or patients who have experienced malpractice. And he's a terrific writer.
While I was reading Better, the Obama administration announced that it was appointing Dr. Don Berwick as its new Medicare/Medicaid chief. Like most people outside medicine, I never would have heard of the guy without this book.
Gawande describes Berwick's influence on health practice in this way:
Now Berwick is going to be powerful because he will have oversight of billions of government money going into the new system. Maybe this new health scheme will change more than who pays who for the bills.
Berwick will face a confirmation fight -- Republicans will fear the patient-concerned doctor can make reform popular. Health activists will need to afflict our more wavering Senators on this one.