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| Technology |
In his 1999 New Yorker article titled "When Doctors Make Mistakes," Dr. Atul Gawande uses his experience as a surgeon to make a general claim about technology. Peppered with stories of medical malpractice, Gawande's article makes clear the fact that no matter how expert the doctor, room always remains for error. He contends that the main thrust of medical training should not be to protect us from bad doctors but rather from good ones. The sheer volume of cases that pass through the hands of competent, well-intentioned doctors each year almost guarantees that a "silly" mistake will have dire consequences.
Gawande's prescription for this malady is somewhat unorthodox. Rather than proposing increased training or harsher malpractice statutes, he suggests that more foolproof protocols be devised.
Every year, several surgeons accidentally operate on the wrong side. Intending to repair a ligament in the left knee, they instead slice open the right. Obviously, this is rare, but it seems that it should be eliminated all together. Clever doctors invented a foolproof method for ensuring that the surgeon operates in the correct place. The American Academy of Orthopedic Surgeons now endorses the practice of surgeons initialing the body part on which to operate before the patient comes to surgery.
The article contains myriad other examples of processes that reduce the already infrequent incidence of errors in the medical profession. Anything from standardizing the direction that anaesthesia knobs are turned to reduce the flow of gas to decision trees used by emergency room doctors can be considered technology. Following several successes in this arena, Gawande wrote a book titled The Checklist Manifesto. He argues that no matter how expert a professional is, checklists can improve his or her outcomes.
His book brings to mind perhaps the most famous checklist in common use--the pilot's preflight checklist. Before taking off, pilots must complete an extensive checklist intended to eliminate common oversights and ensure the plane's ability to fly safely. This checklist is one of the reasons that air travel is one of the safest modes of travel. It is also a prime example of a process that doubles as a piece of technology.
Another excellent example of an industry in which processes are part of the technology, ironically, is the software development industry. Authors, bloggers, and columnists have pontificated ad nauseum about the value of disciplined software development practices... and they are absolutely justified. Sloppy or lazy development can multiply the final amount of effort required to build a piece of software by a factor of ten or more--something I have experienced.
Frederick Brooks, Jr's book The Mythical Man Month is perhaps the canonical resource on the topic. Written in 1975, the fact that it still ranks #7 in Amazon's entire software engineering category is a testament to the durability of its wisdom. Some aspects of the book are dated (e.g. weighting the size of the source code of a program heavily because storage was so expensive), but the basic thesis is enduring. He argues that adding extra man-power to any behind-schedule project that involves complex interdependencies will only cause the project to fall further behind. The overhead involved in bringing new members up to speed and maintaining communication among the enlarged team is insurmountable.
Brooks's book is an example of a piece of knowledge that was invented by man, solves a problem, and makes life easier. If that isn't technology, then I don't know what is. This fact requires a broadening of our conception of technology to include all manner of managerial, medical, and professional processes. In addition to writing about technology, the work of Gawande and Brooks should be considered technology in and of itself.
Well it's a good thing these doctors are getting shear volume of cases instead of normal volume of cases. I hear they have a pretty good shear modulus, but their Young's modulus is a little iffy.
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