Atul Gawande

American surgeon, public health researcher, and staff writer at The New Yorker, best known for The Checklist Manifesto (2009) and Being Mortal (2014). A general and endocrine surgeon at Brigham and Women’s Hospital in Boston, Gawande also founded Ariadne Labs — a joint centre of Harvard Chan School of Public Health and Brigham and Women’s Hospital — to apply scientific methods to healthcare delivery. He served as chair of Haven, the Amazon–Berkshire–JPMorgan healthcare venture, and was confirmed in 2022 as Assistant Secretary for Global Health at the US Department of Health and Human Services.

His writing career began with a fellowship that placed him in the Clinton White House working on health policy, which he later reflected on with ambivalence regarding welfare reform outcomes. His New Yorker essays — collected across four books — are designed to remain readable five years after publication: timely in concern, durable in argument.

Core positions

Medicine’s central challenge is no longer knowledge but organisation. Gawande holds that the volume of knowledge and skill required to treat patients well has outgrown what any individual clinician can hold, and that the profession’s failure to teach teamwork — how to function in groups, how to diagnose when a group is failing — is its most consequential gap. The checklist is his signature practical intervention, drawn from aviation’s pre-flight procedure: a structured pause that forces introductions, shared goal-setting, and review of critical risks before high-stakes action begins. In trials across eight cities, the surgical safety checklist cut death rates by 47 per cent; the mechanism is not compliance but attention — turning people’s brains on.

On end-of-life care, Gawande argues that the standard clinical model — giving patients options and asking them to choose — is badly misaligned with what patients actually need. Clinicians do 95 per cent of the talking; patients do 5 per cent; treatment is routinely mismatched with the patient’s own priorities for quality of life. Eliciting goals first, then recommending what best fits them, is both more humane and produces better outcomes on conventional measures.

He is cautiously optimistic about technology in medicine — wearables he calls underrated, AI diagnosis he calls far harder than its proponents believe — and critical of the FDA’s post-market surveillance, which he sees as chronically under-resourced relative to the speed at which drugs are approved.

In the wiki

• Atul Gawande on Priorities, Big and Small — Conversations with Tyler, Ep. 26: checklists, end-of-life care, medical education, the FDA, and the Gawande production function