Atul Gawande, M.D., spoke to 500 members of the Medical & Dental Staff and other Lancaster General Health leaders April 5 at Spooky Nook Sports.

Health care has reached a pivotal moment, renowned surgeon, author and speaker Atul Gawande, M.D., told a Lancaster audience April 5.

In a single century, medical advances have helped to virtually double life expectancy. We now have the knowledge – as well as 6,000 drugs and 4,000 medical and surgical procedures – to treat most of the 70,000 conditions that can cause the human body to fail.

“We are committed to the idea that every life is of equal worth and deserving of equal respect,” Dr. Gawande told 500 members of the Medical & Dental Staff and other Penn Medicine Lancaster General Health leaders. “Our job has become to deploy this new capability town by town, to every person alive. This is arguably the most ambitious undertaking ever.”

In a Thursday evening speech at Spooky Nook Sports, Dr. Gawande emphasized the importance of innovation, standardization and teamwork, and the changing role of the physician. The event kicked off the Distinguished Healthcare Scholar Lecture Series, which commemorates the 125th anniversary of Lancaster General Hospital.

“Tonight we start the conversation around quality and safety, and things we can do together to improve the health of the communities we serve,” LG Health President & CEO Jan Bergen said in her introductory remarks.

Dr. Gawande said health-care leaders are still determining “rules of the road” for working together to create systems that work best for both patients and clinicians. Identifying key practices from successful programs serves as a useful guide for developing standard work, he said. Following a checklist, for example, can significantly reduce complications and mortality.

“We are trying to transform our work in health care,” he said. “We are still understanding how to do that.”

Dr. Gawande also spoke of lessons learned from treating patients with serious illness through his latest book, “Being Mortal.” Physicians should envision themselves not as technicians, he said, but as counselors, guiding patients to make decisions that best serve their priorities and goals.

“People have priorities in life they want us to serve as clinicians,” he said. “Those priorities are different from person to person, and they change over time. In order to learn what those priorities are – and this is highly technical – you have to ask them. We don’t ask.”

Ideally, physicians will provide care that matches the patient’s goals, Dr. Gawande said. Patients usually don’t want to survive at all costs but instead hope to live as good a life as possible until the end. He recalled one patient who simply wanted to be able to eat chocolate ice cream and watch football on TV.

Dr. Gawande praised Penn Medicine’s successful adoption of a toolkit designed to help physicians have difficult conversations with patients facing serious illness. He also commended LG Health’s efforts around continuous improvement.

“We have a higher purpose … using our medical capabilities to help people live the life they want,” he said. “This is hard. This is a generation’s worth of work. This is the work we get to do.”


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