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Recommended Reading

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Here are some recommended articles written by Atul Gawande and published in The New Yorker.

The Cost Conundrum

Gawande researches one of the most expensive hospitals in America, while comparing it to a much more cost-effective neighboring hospital serving a demographically similar community.

He writes, “health-care costs ultimately arise from the accumulation of individual decisions doctors make about which services and treatments to write an order for. The most expensive piece of medical equipment, as the saying goes, is a doctor’s pen. And, as a rule, hospital executives don’t own the pen caps. Doctors do.”

The Hot Spotters

Gawande explores initiatives aimed to reduce costs and improve outcomes for chronically expensive patients. This “hot-spot strategy” involves greater ownership of a patient’s care from physicians, and the promotion of preventative measures. If increasing comprehensive care and physician accessibility can lower health care costs, perhaps the development of “medical homes” and “accountable care organizations” in the Affordable Care Act can realize the benefits of local initiatives on a national scale.

Big Med

Using the Cheesecake Factory as an example of large chains providing a standardized experience with quality control and efficiency, Gawande asks how a similar model that promotes best practices could be applied to health care. According to surgeon John Wright, “Customization should be five per cent, not ninety-five per cent, of what we do.” But scaling best practices, as Gawande argues, is one of the “deepest problems in medicine.”


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