By describing how good hospitals and surgical centers could be, Atul Gawande indirectly--and likely without intending to do so--describes quite a number of ugly truths about how they actually are.
The truth is, more likely than not, the surgery team cutting you open isn't a coherent team. They likely don't even know each others' names. Surgeons as a rule generally resist using basic checklist procedures to prevent infection risk and catastrophic errors. In fact, Gawande finds surgeons often offended by the very idea!
Worst of all, the hospitals they work for likely don't even know--and don't want to know--their error rates, complication rates, infection rates and death rates. After all, what's the incentive to track data that might make you look bad?
The idea that it could be as difficult as Gawande finds it to get surgery teams to use basic checklists (something the airline industry has done for generations to produce astoundingly good safety records) is staggering. But it illustrates an excellent example of a "skin in the game" problem, and it explains why pilots are happy to use checklists if they improve safety, while surgeons ego-resist the idea.
Why? Because the pilot is actually on the plane with you. The moment the surgeon closes you up and ships you off, you become somebody else's problem. On to the next patient.
Finally, this reader received from this highly useful book one more valuable--and almost certainly unintended--message: Do not have surgery unless absolutely necessary.