Bookmarks Issue: 
Atul Gawande

How to Get Things Right

A-ChecklistManifestoAtul Gawande, a surgeon and New Yorker staff writer, is also the author of Better: A Surgeon’s Notes on Performance and Complications: A Surgeon’s Notes on an Imperfect Science.

The Topic: In 2008 Dr. Peter Pronovost of the Johns Hopkins Hospital received a MacArthur "genius" grant for an idea that might seem pretty simple: use a checklist. Nevertheless, Pronovost’s checklists—used to help manage a wide variety of minor tasks in the hospital and generally enforced by nurses, not doctors—have been shown to significantly save money, time, and lives. After telling the story of Pronovost’s reforms, Atul Gawande explains how he implemented checklists in his own operating room and then led a study that demonstrated their effectiveness in clinics throughout the world. Finally, Gawande inquires into the origins of checklist protocols (the aviation industry) and considers how their use might improve nearly every aspect of modern life.
Metropolitan Books. 224 pages. $24.50. ISBN: 9780805091748.

New York Times 4 of 5 Stars
"Gawande’s missionary zeal can give the book a slanted tone. For instance, there is almost no discussion of the unintended consequences of checklists. … Yet despite its evangelical tone, The Checklist Manifesto is an essential primer on complexity in medicine." Sandeep Jauhar

Seattle Times 4 of 5 Stars
"This is a brilliant book about an idea so simple it sounds dumb until you hear the case for it. Atul Gawande presents an argument so strong that I challenge anyone to go away from this book unconvinced. … Gawande has written a short, readable, sensible book and is highly recommended." Bruce Ramsey

Washington Post 4 of 5 Stars
"While many surgeons are autonomous rulers of the operating room, he argues that decentralizing power among nurses, anesthesiologists and other physicians increases communication and reduces error. Thoughtfully written and soundly defended, this book calls for medical professionals to improve patient care by adopting a basic, common-sense approach." Sarah Halzack

NY Times Book Review 3 of 5 Stars
"The story of the Hopkins I.C.U., and many other stories from The Checklist Manifesto, will be familiar to loyal fans of Dr. Gawande’s amazing New Yorker article. … But in his effort now to apply the checklist to all walks of life—venture capitalists, skyscraper construction workers, restaurant chefs—he occasionally treads uncomfortably close to the territory claimed by his New Yorker colleague Malcolm Gladwell, taking a single idea and trying to make it fit almost every situation." Robin Marantz Henig

Wall Street Journal 2.5 of 5 Stars
"Dr. Gawande is right to note that checklists are indispensable in situations where a small mistake can lead to tragic consequences, as in surgery. But his call for a broad checklist regime would be counterproductive—fraught with all the dangers of bureaucracy and excessive law." Philip K. Howard

Critical Summary

Gawande’s previous books were considered exceptional because he dropped the mask of the omniscient surgeon and gave readers an honest look at how mistakes happen in medicine and what doctors do in response. While The Checklist Manifesto is based in that same essential humility, Gawande is uncharacteristically insistent on the usefulness of checklists to other fields. While many reviewers were clearly convinced, others asked if Gawande went a bit too far, pointing out scenarios where checklists can be annoying or even counterproductive. Nevertheless, when it comes to his ability to tell interesting stories in engaging prose, critics felt that Gawande dotted every "i" and crossed every "t."