A Conversation with Atul Gwande

Atul Gawande joined Michael Peterson on stage for an impromptu one-on-one conversation about how healthcare delivery reform can help reduce costs and improve quality of care. The session served as an in-depth introduction to the Summit’s broader healthcare panel later in the day.

Gawande and Peterson began by discussing the difficult but important subject of end-of-life care, which has significant implications for the U.S. healthcare system. Gawande said, “The reality is we’re making many bad choices towards the end of life.” He said a lack of adequate planning often leads to decisions that cause more harm than good and increases suffering.

Gawande highlighted the importance of palliative care communication — clinicians having in-depth conversations with their patients about goals and values — as a key way to reduce suffering and improve quality of care.

Peterson discussed the work of the Peterson Center on Health- care, which focuses on identifying, validating, and spreading solutions that lower cost and improve care. Gawande noted the difficulty in scaling that sometimes exists because of a lack of physicians or other resources.

Gawande emphasized one evidence-based tool that is being scaled around the world with impressive results. The Surgical Safety Checklist, developed by Gawande and a team of experts with the World Health Organiza- tion, has been shown to reduce surgical complications and mortality by 18 to 47 percent.

Simple tools like checklists hold great promise for “better, more efficient, lower-cost, higher- quality healthcare delivery.”