Cowboy doctors? Cowboy teachers - surely not!

A delightful and interesting essay in the New Yorker, Cowboys and Pit Crews by Atul Gawende, who is a surgeon and staff member at Harvard among other amazing achievements, says that medicine is practised according to its cowboy roots in the 1930s and now in a much more medically complex environment should work more like a pit crew. A pit crew is a highly coordinated team working on a task rather than the individualistic cowboy approach that he says still exists. Gawende says that in the 1930s a doctor could carry around his patient records in his head and his treatments were quite limited in number and complexity. He says this leads to a cowboy culture, where highly individualistic doctors act according to their own judgements when in fact they depend on a growing team of fellow professions and specialists. In other words he is saying a lack of team work is damaging health delivery. He says, "A structure that prioritizes the independence of all those specialists will have enormous difficulty achieving great care."

Well, isn't this the same criticism that is being made of our traditional school culture, where the classroom teacher is in almost full control of her methods of teaching and the tradition of privacy blocks accountability? It seems that from every quarter there is more evidence that intelligent collaboration works better than

By the way, Gawende points out, in conclusion, that modern cowboys are very sophisticated in their cattle management and work in well coordinated teams!