Cowboys and Pit Crews

Atul Gawande, in this year's commencement address at Harvard Medical School, talks about the challenges of modern medicine. It has become a much more complex process than it used to be. There are too many skills needed and too much knowledge needed that no doctor can do it all himself. Medicine is now administered by teams of skilled practitioners. But we still train our doctors as if they were the focus of medical delivery.

The public’s experience is that we have amazing clinicians and technologies but little consistent sense that they come together to provide an actual system of care, from start to finish, for people. We train, hire, and pay doctors to be cowboys. But it’s pit crews people need.