OUTLIERS--The Story of Success

Malcolm Gladwell is one of my favorite authors. His last two books, the Tipping Point and Blink, became best sellers. I reviewed both books in our Jefferson Health Policy Newsletter in 2001 and 2005, respectively. His newest book, OUTLIERS-The Story of Success, is another hit!! I especially enjoyed chapter 7--The Ethnic Theory of Plane Crashes. This could serve as a primer on the basic tenets of Crew Resource Management--the study of improved cockpit communication and its connection to safer flights and fewer crashes. Essentially, CRM teaches pilots, copilots and other crew members a standardized form of communication that empowers everyone to participate in a safe flight. It reduces "mitigated speech" patterns and helps to preserve communication "against the authority gradient" with out punitive damages. I am convinced that healthcare teams could use a heafty dose of CRM and that training programs across most hospitals would benefit as well. Imagine for a moment a team making rounds that chooses to ignore the third year student who has a crucial piece of history, taken from the patient, that may dictate a change in therapy?? Would your team be willing to listen to the lowly third year student, especially if her information would contradict what the attending has already decided?? Think about it, and let me know!! DAVID NASH