To that end, Gawande calls for a redirection of funding, a diversion of some of the money that's now spent on research into new cures toward an improvement in the way medical professionals use existing resources. They must cultivate "a science of performance," a constant striving to improve the way they use the techniques, instruments, medicines and facilities available to them. After all, doctors, nurses and hospitals deal with questions of the quality of life, and often with matters of life or death. A surgeon who teaches at Harvard Medical School, Gawande insists that in his profession, "good enough" is not good enough. "The paradox at the heart of medical care is that it works so well, and yet never well enough," Gawande asserts. The modesty of its title, Better: A Surgeon's Notes on Performance, doesn't even hint at how controversial some parts of the book are. Atul Gawande's new book has elements of all these, but it's also something more startling and radical. LAURA HANIFIN/METROPOLITAN BOOKSÄ«ooks by physicians tend to be either advice for the layperson, memoirs of poignant or funny encounters with patients, or discourses on disease as the interface between life and death. Atul Gawande calls for diligence and more competition.
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