"Better: A Surgeon's Notes On Performance" Book Writeup

October 14, 2012

Better: A Surgeon's Notes On Performance Book Cover Better: A Surgeon's Notes On Performance Atul Gawande ISBN: 0805082115

What’s the point?
How can you improve when the cost of failure is so high? Medicine is filled with high risk decisions where the consequences of making the wrong choice can result in the loss of human life.

While the stakes in developing software are rarely as dire, we can apply lessons from medicine to improve our own processes and abilities.

How was it?
At first glance, it is easy to dismiss this book and say that software is nothing like medicine. But both professions have to deal with complexity, imperfect information, communicating with “clients”, and the challenges of working with teams.

As I read the book, it was surprising how many parallel connections I could make to software.

Battlefield surgeons perform “patch job” operations and then transfer wounded soldiers back to hospitals to receive more care. The surgeons used data to identify patterns of injuries and optimized their care. In software, we have hot-fixes and track application errors to predict bug reports.

Obstetricians came up with a metric (the Apgar Score) that provided immediate feedback about the condition of a newborn child and allowed for objective comparison. Remind anyone else of the recent industry trends of validated learning and metric driven development?

My favorite part of the book was the concept of “positive deviance”.

Gawande describes how some performers are able to consistently ride the upper tails of the bell curve by identifying and maximizing small changes that result in positive outcomes.

Being 99.5% effective vs 99.95% effective doesn’t seem to make a difference in a day — but tally that 0.45% difference up over a year the result is 83% vs 16%. A very powerful example of gradual improvement if you ask me.

Who should read it?
There are good lessons for every developer in this book. Before you reach for the next software book about improvement, performance, or team dynamics give this cross-disciplinary book a shot; I think you’ll be glad you did.

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