Cooperating for better care.

News & Views

Gawande: Medicine needs ‘pit crews’

Share this:




Famed physician-writer Atul Gawande, M.D., says that patient outcomes depend just as much on well-coordinated teams as they do on technically skilled clinicians. Dr. Gawande is  a health-policy professor at the Harvard T.H. Chan School of Public Health and a staff writer for The New Yorker. He made his remarks at the recent Medical Group Management Association 2015 Annual Conference.

As example, Medscape reported,  “he described the case of Duane Smith, who was involved in a car accident and was left with broken limbs, a fractured pelvis, collapsed lungs, and a ruptured, hemorrhaging spleen, which had to be removed.

“Smith pulled through after a 3-week stay in an intensive care unit, but did not receive the three vaccines that would guard against streptococcus and other bacteria that the spleen normally clears.

“Two years later, during a beach vacation with his wife and daughter, Smith came down with an ordinary strep infection that his body was powerless to combat, and developed sepsis.

“‘He survived, but he lost all of his fingers, all of his toes, and his nose,”‘

“It’s not clear where the breakdown was. Some people thought the outpatient physicians would take care of it. Some people thought maybe the ICU would take care of it. The ICU thought maybe the surgeons would take care of it. But it didn’t happen,” Dr. Gawande said.

“We have trained, hired, and rewarded physicians for being cowboys, but it’s pit crews that we need for our patients. Teams of clinicians deliver far better results than autonomous specialists, each doing their own thing.”



Contact Info

(617) 230-4965

Wellesley, Mass