Atul Gawande's Better: A Surgeon's Notes on Performance does a wonderful thing that is rarely done: it tells us what it is like to be in a practice.

A practice is uneasily poised between a profession and a craft, with some science and art mixed in. Think law, management, medicine, teaching, many types of engineering. With so many people in these professions, one would think that there would be thousands of books like Dr. Gawande's. But there aren't, so let's be grateful for this book (as well as its excellent predecessor, Complications: A Surgeon's Notes on an Imperfect Science).

The beauty of Better is that it lets you see and feel what it's like to face the near-constant uncertainty of being a physician. The book consists of a dozen short essays, many originally published in The New Yorker. The book focuses on two main questions: how does one improve a practice and how can we do things better when we don’t have all the information we’d like. Thus, the book's title.

This emphasis on performance can be just as valuable to managers as to physicians. Gawande, in several essays, discusses the interesting concept of being a "positive deviant"--someone whose performance is exceptional without having more knowledge. He discussses the values of counting things in one's work, of writing things down, of listening to everyone who has important things to say, and becoming an early adopter, always searching for new things to try and say and do.

There is much more here for anyone interested in how practices work and how to do better within an established practice. The author, the son of two physicians, is steeped in how being a physician actually works. He lets us all in to this remarkable world and I only wish that exceptionally reflective practitioners in other fields would do the same.

RECOMMENDED READING:
Better: A Surgeon's Notes on Performance