Wednesday, July 08, 2009

"Bedside Ingenuity" Tackling Old Problems in New Ways

Atul Gawande, author of Better: A Surgeon's Notes on Performance, is inspirational, not only to the medical profession, but to all of us, to make better use of the knowledge we already have,

In order to better ourselves it is not always necessary to discover the new; it is just as important to continuously assess the performance of the confirmed procedures currently used, always willing to acknowledge and interrogate failure in order to find a better solution.

Dr. Gawande emphasizes the importance of applying "bedside ingenuity" when it's obvious that standardized methods are failing to improve the situation. Sometimes it's necessary to throw away the textbook and allow the mind to explore old problems in new ways. We often hear the phrase "thinking outside the box", especially as it relates to gaining employment. "Bedside ingenuity" takes that phrase one step further by requiring introspection, reflection, and a genuine concern for what we are tying to either repair or change.

The three core requirements Gawande describes for success in medicine could easily be applied to many other situations.

Diligence – attention to detail.

To do right — despite moral obstacles.

Ingenuity – arising “from deliberate, even obsessive, reflection on failure and a constant searching for new solutions."

Take a grocery clerk whose main job is bagging people's groceries. Most of us would think this is a fairly insignificant position having very little impact in the grand scheme of things and that it would be silly to think we could apply any of this to performing a job like that. An elderly person or a person in poor health would disagree. The grocery clerk's performance; the way he packs bags treats the person, whether or not he offers additional help could very possibly go a long way in determining the kind of day that person may have.

The stakes are higher in medicine than probably any other field because the smallest mistake, oversight, lack of reflection, introspection or concern, can lead to loss of life. Fortunately, for most of us, this is not the case, but because most of what we do whether it is shampooing a person's hair, bagging groceries or presiding over a country..."We the People" have a much bigger impact on the lives of others than we think.


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