The Checklist Manifesto

How to get things right.

By Atul Gawande | Reviewed by Eric Cardin, PT, MS

“I’m not a business person, I’m a physical therapist.”

This statement probably comes second to “This time it’ll be different” for the shortest but most powerful and dangerous statement in the business of physical therapy. The truth is that physical therapy education spends very little time preparing aspiring therapists to navigate the complexities of the health care marketplace. Most gain their management/business bona fides via the School of Hard Knocks (or the equally unforgiving but fruitful School of Trial and Error), but we can supplement those experiences with the words and wisdom of others. Books on communication, relationship building, marketing, and strategy abound.

Boston-based surgeon and renowned author Dr. Atul Gawande, MD, MPH, gives us The Checklist Manifesto: How to Get Things Right and opens a frank and honest discussion of how important tasks are often routine. A simple checklist can remove or at least corral the complexities. His writing infuses just enough anecdote and hard evidence to support his claims.

But what to take from this book as a business person? The story Dr. Gawande tells starts and ends in complex environments such as operating rooms and the construction site of a skyscraper. Clearly, in these workplaces poor decisions or missed steps can have catastrophic results. Luckily for the average physical therapy clinic owner, the choices are not as dire. Yet the concept is highly valuable. Think about all the decisions a business owner and physical therapist has to make in a day or a week. What parts of those decisions or entirety of those decisions are routine? There is always something that you should be thinking about, checking on, and ultimately making a decision about. Decision fatigue is real! Revisiting issues that ultimately have been decided is frustrating. Missing key details just because you have hundreds of details to manage is pure folly. A simple solution? Look at processes to determine what are the important components whose omission results in compounding problems and use a checklist to reduce or eliminate the chance of mistake.

Eric Cardin, PT, MSPT, is a Private Practice Section member and executive director of South County Physical Therapy, Inc., located in Auburn, Massachusetts. He can be reached at ecardin@sc-pt.com.