Cowboys and Pit Crews

Atul Gawande delivered this year’s commencement address at Harvard Medical School, the whole thing is worth reading if you have at all an interest in the way things change, the way things work or health care in general.

Gawande uses the analogy that doctors of past generations were cowboys and what patients need now to navigate the byzantine complexity of health care information and services is actually more like a NASCAR pit crew — a team of health care professionals/specialists all working in harmony for a common, greater good.

Recently, you might be interested to know, I met an actual cowboy. He described to me how cowboys do their job today, herding thousands of cattle. They have tightly organized teams, with everyone assigned specific positions and communicating with each other constantly. They have protocols and checklists for bad weather, emergencies, the inoculations they must dispense. Even the cowboys, it turns out, function like pit crews now. It may be time for us to join them.

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