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Dr. Atul Gawande | by Center for American Progress
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Dr. Atul Gawande

The average American will have nine operations before the age of 85. Surgery accounts for half of all hospital admissions and over 40 million inpatient operations per year in the United States. These procedures carry an inherent risk—globally, major surgical complication risks range from 3 to 16 percent, and death rates from 0.2 to 10 percent—yet there is remarkably little effort to discover how to reduce surgery’s high rate of complications, ensure access to surgery, reduce unnecessary surgery, or understand how to make its provision more cost-effective.


This is emblematic of a distortion in thinking about where the risks in healthcare are—or how policy can help ensure medicine saves more lives. Pharmaceuticals get the headlines, but are only a fraction of life-saving care. And while federal funding has supported an enormous output of new discoveries, there has been little recognition of the need to ensure these discoveries are effectively put into practice and reach ordinary Americans wherever they seek care. At least half of the major complications that occur in hospital care such as surgery are avoidable with existing knowledge. Recent findings indicate that simple tools like checklists can transform that care to make it safer, more effective, and less expensive.


Through the Center for Surgery and Public Health, Michael Zinner and Atul Gawande are developing strategies for improving the quality and safety of technological care like surgery, enhancing our understanding of how such care is distributed across socioeconomic and racial/ethnic lines, and charting a path toward expanding nationwide access to higher quality care. The Center for American Progress held an engaging presentation and a lively discussion of the policy dimensions of their important work.

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Taken on April 9, 2008