( CNN ) -- In the years before penicillin came into wide use in the 1940s , medicine could n't do very much for many of the sickest patients . A hospital could keep you warm and provide food and nursing care , but as surgeon and writer Atul Gawande pointed out , in many cases the patient would do no better than if he or she had stayed home . In those days , doctors who mastered the few techniques that could make a difference , such as setting fractures and treating certain kinds of heart conditions , were seemingly all-powerful , Gawande told the TED2012 conference in March . `` A doctor could kind of know it all and do it all , '' he said in an interview with CNN following his talk . Doctors were rewarded for being cowboys , for being daring and self sufficient . Today , the world of medicine promises and provides much more -- cures and care for many of the worst health problems people have . But doctors can no longer know everything and do everything . As medical knowledge has exploded , doctors increasingly must specialize in a field to absorb all the relevant information to treat a certain kind of illness . And a patient who goes to a hospital often winds up being treated and cared for by as many as 15 doctors , nurses and therapists , Gawande said . The result ? `` Well , it 's been a disaster , '' he said . `` We have 40 percent of coronary artery disease patients who receive incomplete or inappropriate care , we have 2 million people pick up infections in hospitals because one of those people on that team failed to follow basic hygiene practices . '' Watch Atul Gawande 's TED Talk . `` Holding on to our streak of autonomy , each of us , we end up losing the patient in between , '' he said . Gawande , a surgeon at Brigham and Women 's Hospital in Boston , also is a researcher at Harvard University and a writer at The New Yorker . Today doctors are still often rewarded and trained as cowboys , but Gawande says what we really need are doctors who can function as members of a team , the way those in an auto racing pit crew work together to get vehicles back in the race . Ted.com : Trial , error and the God complex . Gawande has been a pioneer in advocating the use of checklists by medical teams working together in surgery or on other procedures . `` We 've had checklists in medicine for people we considered the lowest on the totem pole , but the idea that the surgeon would have to follow a checklist is anathema , '' Gawande said . But in fact , he added , `` when checklists have been used to make sure even the best , most specialized doctors do n't miss key steps in providing care ... we 're finding that carefully designed checklists cut death rates in half in surgeries , that they can eliminate certain kinds of infections and that they can slash costs . '' Gawande has found reason to question the assumption that the most expensive care must be the best care . `` What we 're discovering is that the best care , the places getting the best results , are often among the least expensive , '' he said . In those places , doctors and nurses providing care function like teams . `` We are going through a dramatic change where it 's no longer about what your doctor knows , it 's about what a team of doctors , nurses and others are able to do together . '' TED.com : Doctors make mistakes -- can we talk about that ? These days Gawande brings a checklist with him into the operating room . At first , it was a bit of a shock for him . `` I did it reluctantly . I have been someone who believes , you know , do I need a checklist ? No ... but i did n't want to be a hypocrite . I was bringing them to Tanzania and Seattle , so I started using a checklist myself . So that meant before the patient went to sleep we would do a series of checks -- not just , 'Do we have the right person and the right side of the body ? ' But also , 'Do we have a plan for what happens if this is a high-blood-loss case ? ' `` Before the incision , we 'd introduce ourselves by name because it would turn out often that you would have a team of people working together for the first time who may not know each other very well . `` We discuss the plan in detail , and in doing these things I found from the very beginning that we were catching problems that we were missing otherwise . The anesthesiologist or the nurse was noticing things that I had missed . `` I have not gotten through a week of surgery in three years using this kind of checklist without it catching something that was a danger for the patient or would have made the care better . ''
John Gawande : He revolves around the idea of the ` ` cowboy '' doctor . He says today 's doctors do n't know it all ; they have to specialize and be part of a team . He says strong teams in medicine produce the best results and provide care more cheaply . Gawande : Today 's doctor must interact as if he were part of an auto racing pit crew .