Atul Gawande gave the commencement speech at Stanford Med School this year. Long-time readers know I am programmed to read everything he writes (The New Yorker really has a murderer's row of regular contributors). His talk hit on many topics he's written or spoken about recently, including health care costs and the complexity of the health profession. The latter was the focus of his latest book, The Checklist Manifesto, which I read earlier this year. Its thesis: using a simple checklist is one of the most effective ways of coping with the complexity of so many modern challenges.

It sounds almost too mundane a topic for a book, even as slim as it is, but when the costs of a misstep are as high as they are in medicine, it seems negligent to ignore the possibilities. From his commencement speech...

Having great components is not enough. We’ve been obsessed in medicine with having the best drugs, the best devices, the best specialists—but we’ve paid little attention to how to make them fit together well. Don Berwick, of the Institute for Healthcare Improvement, has noted how wrongheaded this is. “Anyone who understands systems will know immediately that optimizing parts is not a good route to system excellence,