Last month, the surgeon-writer Atul Gawande gave a much talked-about commencement address at the Harvard Medical School entitled “Cowboys and Pit Crews.” Gawande’s argument, in essence, is that doctors’ conception of their work needs to undergo a major paradigm shift. As members of an elite, specialized profession, they have traditionally prized—and clung to—ideals of independence, autonomy, and self-sufficiency. But, Gawande contends, medical knowledge and processes have become so complex (and so prone to error and inefficiency) that doctors must begin to think more about how they can operate within effective treatment systems or teams. “We train, hire, and pay doctors to be cowboys,” he says. “But it’s pit crews people need.”
Reading the address, it’s hard not to be struck by the many parallels to ideas currently swirling around education and the teaching profession. In discussing the skills doctors need to function in systems, Gawande emphasizes the use of data to understand performance and the ability to devise solutions for structural problems and implement changes “at scale.” He also stresses the need for discipline and an acceptance of some level of standardization. And he notes that resistance to this kind of coordinated approach often “surfaces because medicine is not structured for group work.” That probably applies doubly for schools.
Despite such resistance, Gawande believes that, for doctors, a more systematic, team-based model is clearly the way of the future. “We have every indication,” he says, “that where people in medicine combine their talents and efforts to design organized service to patients and local communities, extraordinary change can result.”
Does the same hold true for education?
Updated with additional information, June 9
A version of this news article first appeared in the Teaching Now blog.