29 Nov 2010

Today’s absolute highlight is Atul Gawande. I am a big fan of his books, which I think every doctor should read, reread and then read again. And today he’s giving a talk at our own RSNA. What an honour.

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Prior to his talk Sam Gambhir gave the Pendergrass new horizons lecture on strategies for early cancer detection. A truly impressive talk, on the ultra-high-tech developments for cancer detection in the earliest of stages, but it very much reminds me of the 7T MRI discussions: there’s this niggling question in the back of my mind whether we can really justify all this expensive equipment and research while in large parts of the world children die of diarrhea…

The contrast with Gawande’s subsequent talk therefore couldn’t be bigger. The simplest technology possible, a checklist, reduces post-surgery mortality by 45-50%. It is really impossible to believe. All we can do is hope and pray that these simple measures really make their way into clinical practice as soon as possible so they can start taking their effect. We can have all the high-tech shiny toys we want, but if we don’t stick to the basic principles such as hygiene, haemorrhage control, and patient follow-up, we are only making health care more expensive, but not better.

I was left deeply impressed and truly inspired, yet again, by this amazing person. Please, read his books and be a better doctor.