We tend to remember the one wasteful case and forget the next 25 which were all reasonable - the old man with the worsening shortness of breath, the middle aged

We tend to remember the one wasteful case and forget the next 25 which were all reasonable - the old man with the worsening shortness of breath, the middle aged guy with gross hematuria, the drunk who crashed into a parked car riding his moped, the kid with the early onset puberty for a bone age study. Dr. Gawande is a smart person, a contemporary of Ezra Klein and Ezekiel Emanuel, and a lifelong politically involved leftist. His essays on waste in medicine over the past 10 years have shaped progressive thinking on the subject, with citations from everyone from President Obama (during the sale of Obamacare) and many others. His political alignment is why Dr. Gawande cannot speak the obvious heresy that the United States' insane malpractice climate has anything to do with overtesting (although he has considered that in a prior book). He has made his career promoting the idea of waste and accordingly sees it behind every bush. I don't mention this to say that there is no merit to some of his observations; just to provide context of his background, alignment, and world view.