THE CHECKLIST MANIFESTO BY ATUL GAWANDE


SUMMARY:

In his work The Checklist Manifesto, Dr. Atul Gawande addresses the problematics of complexity and organization within the context of problem solving and minimizing fallibility in our endeavors. Gawande’s basic thesis follows a similar logic to the scientific principle of Ockham’s razor, wherein simplicity is stressed as a cardinal virtue of the problem solving process. In other words, Gawande’s ode to the checklist lies in the notion that problems should be essentially tackled by breaking them down into sufficiently manageable steps, such that an enormously complex problem is viewed as constituted by various individual aspects. This both aids in resolving complexity, while at the same time providing the problem-solver with a certain psychological boost, insofar as what at first seems to be an overwhelming difficulty suddenly appears to be manageable. With its distinct breaking down of the contents of a problem, the form of the checklist is a managerial technique that performs the essential task of the reduction of complexity towards simplicity. Accordingly, it bears a relevance to fields of work where complex problems constantly appear, such as the medical profession.

Within the book, Gawande uses his professional experience and autobiography as a medical surgeon in order to tackle issues of complexity and simplicity. At the outset of the work, Gawande’s main focus is to confront the issue of human infallibility. Referencing the theories of the philosopher’s Samuel Gorowitz and Alistair MacIntyire, Gawande defines the concept of “necessary fallibility” as follows: “Some things we want to do are simply beyond our capacity. We are not omniscient or all powerful.” In essence, fallibility for Gawande is to a certain degree unavoidable, to the extent that we as human beings are finite creatures. For example, we possess certain epistemological limits, which simply means that we are capable of knowing only so much. At the same time, these epistemological limits are also met with the opposite effect of incredible gains in human knowledge, as Gawande phrases it: “We have accumulated stupendous know-how.” The problem is that such accumulation does not surpass our natural limits. As the author phrases this problem, “we need a different strategy for overcoming failure, one that builds on experience and takes advantage of the knowledge people have but somehow also makes up for our inevitable human inadequacies.” For Gawande, this strategy is “almost ridiculous in its simplicity”: it is the checklist.

The checklist becomes an epistemological tool that aids problem-solving. By clearly delineating the specific contents of a given problem, and furthermore denoting how to handle these contents in a particular situation, we effectively synthesize what we already know about a problem with its solution it in a simplified sense. Breaking down the problem in such a bare bone approach overcomes our various human limits, by clearly organizing our own capabilities: by formulating a problem in a checklist form, we are able to break down the immensity of the problem in comparison with our own finite abilities. In other words, the problem itself becomes finite and something manageable when it is reduced to its constitutive parts.

In essence, this is the author’s crucial thesis: that an underlying simplicity is at the basis of any complexity. When introducing this into the areas of management and problem-solving, we essentially de-mystify the apparently insolvability of a given problem. In other words, the problem is just as finite as our own limitations. By using the checklist we basically re-train our approaches to complex problems, learning to look at them in simplified terms. Whereas, as Gawande acknowledges, fallibility is nevertheless unavoidable, he suggests that it can be reduced through a disciplined approach of organization that is found in the form of the checklist.


PRESENTATION

Atul Gawande’s The Checklist Manifesto provides a guide for professionals on how to understand and approach problem-solving. The basic thesis of Gawande’s is as follows: all problems can be reduced to a simpler form, thus allowing the successful management of these same problems. This simpler form is the checklist, which is basically an epistemological tool that allows us to clearly evaluate what factors are constitutive of a problem, thereby allowing us to tackle the latter in a step by step manner that reduces complexity. According to his background in the medical profession, Gawande has seen the value of this technique from his experiences. At the same time, he believes it is also applicable to all professions and any type of problem solving environment. The basic approach of Gawande is essentially scientific in orientation, as a problem is understood in terms of a standard cause and effect relationship: we have to understand the causes that make up a problem, and then address them, in order to eliminate the problem.

At the same time, Gawande can be said to overlook the fact that many times we do not know the real cause or structure of a problem. In other words, there is a lot of guess work present when faced with an extremely complex problem: a problem is not only complex because it is made of many little parts, so that if we break it down, it becomes more manageable. Rather, a problem can also be complex precisely because we do not know everything that constitutes it. In this way, a checklist will inevitably omit key aspects of the problem, and may completely be oblivious to the real cause of a problem, according to the over-reliance on what we already think we know.

Nevertheless, the author makes compelling arguments for why the checklist is a management tool that helps us overcome our finite epistemological limits. The checklist immediately simplifies a problem by clearly delineating what constitutes it. Whereas fallibility, as the author notes, is to a certain extent unavoidable, it is still possible to reduce the possibility of fallibility itself with a symmetrical reduction of the complexity of a problem according to the identification of its constituent parts.