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About the Site:

This is the blog for the book Medical Decision Making: A Physician's Guide, by Alan Schwartz and George Bergus (Cambridge University Press, 2008). The book is now available from Cambridge University Press

About the Authors:

Alan Schwartz, Ph.D. is an Associate Professor of Medical Education and Pediatrics at the University of Illinois at Chicago College of Medicine, where he teaches and conducts research on physician and patient decision making.

George Bergus, M.D., M.A. is the Dr. William and Sondra Myers Family Professor of Family Medicine at the University of Iowa Carver College of Medicine, and Co-Director of the Family Practice/Psychiatry Residency program. He holds a Certificate of Additional Qualification in Geriatrics.

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Review: Better: A surgeon’s notes on performance, by Atul Gawande

June 16th, 2007 by Alan Schwartz

When I was taking my qualifying examinations for my Ph.D. in Psychology, one of my examiners asked me to address what he called the “moon question”: “If human beings are so dumb (according to decision psychology), how did we get to the moon?” The answer, of course, is that despite the predilection in cognitive psychology for inducing and examining error (because error usually provides powerful tests of process models of human behavior), most people are pretty good thinkers most of the time, and some people are very good thinkers most of the time.

Atul Gawande’s excellent 2002 collection Complications: A Surgeon’s Notes on an Imperfect Science struck a responsive chord with medical decision scientists with its insightful examination of medical error. Gawande has now collected 11 new essays in Better: A Surgeon’s Notes on Performance (Metropolitan Books, 2007), which shift the focus to how some physicians come to excel in their craft (in his terms, becoming “positive deviants”). He asks “what does it take to become good at something in which failure is so easy, so effortless?”

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