Some innovations spread fast. How do you speed the ones that don’t?

Atul Gawande in The New Yorker:

Did the spread of anesthesia and antisepsis differ for economic reasons? Actually, the incentives for both ran in the right direction. If painless surgery attracted paying patients, so would a noticeably lower death rate. Besides, live patients were more likely to make good on their surgery bill. Maybe ideas that violate prior beliefs are harder to embrace. To nineteenth-century surgeons, germ theory seemed as illogical as, say, Darwin’s theory that human beings evolved from primates. Then again, so did the idea that you could inhale a gas and enter a pain-free state of suspended animation. Proponents of anesthesia overcame belief by encouraging surgeons to try ether on a patient and witness the results for themselves—to take a test drive. When Lister tried this strategy, however, he made little progress.

The technical complexity might have been part of the difficulty. Giving Lister’s methods “a try” required painstaking attention to detail. Surgeons had to be scrupulous about soaking their hands, their instruments, and even their catgut sutures in antiseptic solution. Lister also set up a device that continuously sprayed a mist of antiseptic over the surgical field.

But anesthesia was no easier. Obtaining ether and constructing the inhaler could be difficult. You had to make sure that the device delivered an adequate dosage, and the mechanism required constant tinkering. Yet most surgeons stuck with it—or else they switched to chloroform, which was found to be an even more powerful anesthetic, but posed its own problems. (An imprecise dosage killed people.) Faced with the complexities, they didn’t give up; instead, they formed an entire new medical specialty—anesthesiology.

So what were the key differences?

More here.