Atul Gawande, M.D., to Deliver Keynote Address at Annual Meeting

“The key understanding that I think we have to come to in medicine is that reform cannot just be about providing insurance,” said surgeon and author Atul Gawande, M.D., M.P.H., in a 2009 interview with Psychiatric News. “We know we have trouble assuring that patients get appropriate care without safety lapses. A lot of it has to do with the fact that we are an industry of highly skilled, hard-working professionals working within a structure that has failed.”

Gawande has become the foremost physician spokesperson for health care reform from the “ground up”—for a change in bedside medicine that emphasizes team-based, population health care focused on quality and value. He will be the keynote speaker at this year’s Annual Meeting in Atlanta, immediately following the Opening Session on Sunday, May 15, in the Georgia World Congress Center. The session begins at 4:30 p.m. and includes addresses by APA President Renée Binder, M.D., and President-Elect Maria Oquendo, M.D.

Gawande is a general and endocrine surgeon at Brigham and Women’s Hospital in Boston and a professor in both the Department of Health Policy and Management at Harvard School of Public Health and the Department of Surgery at Harvard Medical School. He is also the executive director of Ariadne Labs, a joint center for health systems innovation, and chair of Lifebox, a nonprofit dedicated to making surgery safer globally.

A MacArthur “Genius” Fellowship Award winner and New Yorker columnist, Gawande has been named by Time among the world’s 100 most influential thinkers. His three books, Complications, Better, and the Checklist Manifesto, have helped to transform the national discussion about health care reform. His newest book is Being Mortal: Medicine and What Matters in the End.

Gawande has a comprehensive view of what American health care is capable and a practitioner’s grasp of the everyday challenges of health care delivery. He has especially focused on the need for a shift from lone-ranger physicians to teams of cooperating specialists and the new values this shift requires.

He popularized the checklist as a means of coordinating complex work in hospitals, stressing that the simplest kinds of reforms at the surgical bedside can translate into enormous improvements at the level of population health. For example, in the Checklist Manifesto he described a 19-item checklist of the kinds of actions one assumes are routinely performed in surgery—use of an antibiotic, say, or determination of the correct site for surgery. When it was instituted in eight hospitals around the world, the surgical complication rates were reduced by more than one-third.

Gawande was slated to speak at the Annual Meeting in 2009 but was forced to cancel due to scheduling conflicts, so his appearance this year—at a time when many of his ideas are being adopted throughout medicine—is a special treat.

In the 2009 interview with Psychiatric News, Gawande laid out his belief that achieving the excellence of which American medicine is capable will require doctors to be responsible not only to the individual patient presenting in the office or clinic, but to the public at large. That means a new focus on population-based outcomes—in addition to individual outcomes—to determine which treatments work and which ones don’t, to standardize care where possible, and to minimize or eliminate errors to achieve optimal public health benefits.

The same need to incorporate population-based outcomes can be extended to psychiatry, he said then.

“We know we have a broader armamentarium now than we did 10 years ago. But are patients in 2009 getting better faster and more reliably than they did 10 years ago? We can’t answer that.”

So the challenge for psychiatrists, as for surgeons and other specialists, is to adopt a public-health approach to the care of their patients. He posed the question: “Can we take responsibility not just for the individual patient with depression, but all 17 million patients, so we can make their treatment more consistent and reliable?” ■

Gawande will speak at the Opening Session on Sunday, May 15. The session, which begins at 4:30 p.m., will be held in Hall B2, Building B, Level 1, Georgia World Congress Center.