Atul Gawande (Harvard surgeon) argues that despite high levels of training and specialization in surgery, avoidable deaths and disabilities persist. By examining other high-risk fields—skyscraper construction and aviation—he highlights that alongside technology and training, checklists serve as a critical tool to make experts better and reduce preventable harm. The excerpt frames checklists as an unexpected but practical intervention.
Now, our usual tactics for tackling problems like these are to do more training, give people more specialization, or bring in more technology. Well, in surgery, you couldn't have people who are more specialized, and you couldn't have people who are better trained. And yet we see unconscionable levels of death, disability that could be avoided. And so we looked at what other high risk industries do. We looked at skyscraper construction, we looked at the aviation world, and we found that they have technology, they have training, and then they have one other thing. They have checklists. I did not expect to be spending a significant part of my time as a Harvard surgeon worrying about checklists. And yet what we found were that these were tools to help make experts better.
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