Atul Gawande is trying to expand the conversation about care at the end of life with his new book, Being Mortal, which has indicated excessive amount of time and effort trying to convince doctors to change the way they practice.
Various procedures and mechanisms have been used in order to steer physicians and doctors to be adherent to evidence-based guidelines and in the period of accountable care, monetary fines and penalties loom for doctors who show poor results.
In one section of the book, Gawande tells about the improving childbirth conditions in rural India, but he has stressed the need for even better healthcare facilities.
Gawande has specified that only one-third of mothers in rural India receive the medication to prevent hemorrhage. Moreover, less than 10 percent of the babies were given proper warming.
He further added that only 4 percent of birth attendants actually washed their hands for vaginal examination and delivery and physicians followed only 10 of 29 basic recommended practices.
In order to change the healthcare practices, Gawande has discussed the BetterBirth project. The project gives childcare attendants and nurses "mentors" to give personalized instructions and critiques.
In order to change the practice and behavior of the physicians practice, neither incentives nor top-down penalties will be effective.
If you want to change doctors' behavior, you first need to partner with them. People should try to listen and acknowledge what doctors are really concerned about, for instance, physician burnout and medical malpractice. Propose effective solutions to these problems so that physicians get conducive environment to work.