“Jeff Bezos, Warren Buffett and Jamie Dimon did not hire a big-thinking industry outsider to set up a conventional insurance system or haggle with doctors and hospitals over prices. Dr. Gawande was selected to fundamentally change how healthcare is structured, paid for and provided. He was hired to disrupt the industry, to make traditional health plans obsolete, and to create a bold new future for American healthcare…
So, what will the future of Dr. Gawande’s high-profile healthcare venture look like?..
Taking out the trash. It’s estimated that 25 percent of all U.S. healthcare spending (about $765 billion each year) is wasted…
Creating a checklist. Gawande earned national acclaim with his 2009 bestseller, The Checklist Manifesto, inspiring an entire industry to double down on evidence-based medicine…
Being human. In Being Mortal, Dr. Gawande shines an unflattering light on end-of-life care in America, revealing that treatment for our nation’s elderly is often expensive, ineffective and inhumane.
I predict the Bezos-Buffett-Dimon cooperative will become a for-profit company that sells its expertise to dozens, possibly hundreds, of large corporations, each of them eager to offer their employees better healthcare at a lower cost. And once smaller companies see 30 percent improvements in both quality and cost, they too will prefer the new model to the old. And when that happens, the traditional health insurers, hospitals and independent physicians who refuse to change will become obsolete. If you have any doubt, just ask the former CEOs of Kodak or Borders, or the current executives at Yellow Cab, or anyone who has faced the business end of disruptive innovation.
The good news for healthcare’s incumbents is that the change process will likely take five to 10 years to solidify. The bad news is that the clock just started ticking.” (A)
“Dr. Atul Gawande is best known as a surgeon and a writer, but it’s his experience running a Boston-based health research program that may be most relevant to his new role as chief executive of the health care venture spun out of Amazon, Berkshire Hathaway, and JPMorgan Chase.
Ariadne Labs, a partnership between a major Boston hospital and Harvard University, has since 2012 served as a testing ground for projects to improve the quality of health care around the world. The project’s track record, and how Gawande has run it, may be indicative of what’s in store for the company he’ll be heading up starting July 9.
A STAT examination of Ariadne’s work shows that Gawande and his team are willing to push ahead with bold ideas that have the potential to save patients’ lives but don’t always end up working as well as intended in the complex world of health care. It paints a picture of Gawande as a big thinker, ready to empower others and reluctant to micromanage.
“Our tools do work to improve the quality of care, but, in some cases, don’t achieve the result hoped for,” said Deborah O’Neil, director of communications for Ariadne. “We recognize there is more to do.”..
Many of Ariadne’s projects focus on checklists — chief among them, the “safe surgery” checklist, which has its roots in research that Gawande began before Ariadne’s official founding. He developed the checklist along with Berry, and in 2007 and 2008 they tested it in eight hospitals around the world.
The goals of the checklist are twofold, Berry said. “[It was] a conscious attempt to combine both process checks and prompts for team communication.”
At Aspen, Gawande said that checklists are a first step in moving health care from an individual to a team exercise.
Added Tsai, “You need to learn from both the successes and the failures … [and] I think it’s that level of nuance and transparency, which, I think, makes him unique.” (B)
“After interviews with leaders across the world of health care, STAT has identified five challenges Gawande will take on in his new role. Each one carries substantial risks and complications that range from the political, to the personal, to the professional and ethical:
1. Challenge: Controlling costs while improving quality
How: Leverage technology to inform patients, demand lower prices
Risk: Coming off as a corporate stooge, rather than a steward of better health
2. Challenge: Lowering hospital prices
How: Shift care to lower-cost settings, get more employers to join the effort
Risk: Alienating academic centers that dominate some markets
3. Challenge: Cutting out the middlemen
How: Create innovative business solutions that streamline health care’s supply chain
Risk: Alienating key stakeholders needed to access or serve customers
4. Challenge: Attacking chronic disease; and variations in care
How: Leverage technology to improve patient knowledge, contract with select providers
Risk: Changing patient behavior is the hardest thing to do in health care, and may prove costly
5. Challenge: Writing for the New Yorker while leading a national effort to reform health care
How: Carefully selecting subjects and avoiding conflicts
Risk: Compromising the progress of the new venture, or undermining his credibility as a journalist” (C)
“These accomplishments, while esteemed, are merely scratching the surface. Here are nine lesser known things about Dr. Gawande.
6. He tried (and failed) as a rock & roller. Dr. Gawande had a rock band that had many names, one of which was “Thousands of Breaded Shrimp,” he told Boston Magazine. Despite the “terrible” songs he wrote, his girlfriend Kathleen Hobson stayed with him. The two met at Stanford and married in 1992. Dr.
8. He is a recognized genius. Dr. Gawande was named a MacArthur genius in 2006, receiving a “no-strings attached” grant from the John D. and Catherine T. MacArthur Foundation for “extraordinary originality and dedication in their creative pursuits and a marked capacity for self-direction.”” (D)
“In one of his first actions as a CEO, Gawande is planning to travel across the country to meet with the employees he will serve through the health care venture being formed by Amazon, JPMorgan Chase, and Berkshire Hathaway.
Gawande intends to hold one-on-one meetings with a variety of employees who work for the sprawling companies, with the goal of understanding the breadth of their needs and the challenges they face in getting care, according to a person familiar with the plan. The expedition is set to take place in coming weeks and will be done without the involvement of the high-profile leaders of the three companies: Jeff Bezos, Jamie Dimon, and Warren Buffett.
The listening tour will put Gawande face to face with the enormity of his task: lowering costs and improving care for 1.2 million people whose incomes and health struggles are as diverse as their geography. The group includes fulfillment center workers and bank tellers, software engineers and store clerks. Berkshire Hathaway owns companies ranging from Duracell to GEICO to Acme Brick, with a workforce spread through factories, office towers, and shopping malls in rural and urban areas nationwide.” (E)
(A) Why Atul Gawande Will Soon Be The Most Feared CEO In Healthcare, by Robert Pearl, https://www.forbes.com/sites/robertpearl/2018/06/25/atul-gawande-ceo/#3a68e210369b
(B) Ariadne Labs: Atul Gawande’s testing ground for new ideas in health care, by Ike Swetlitz, https://www.statnews.com/2018/06/27/inside-ariadne-labs-atul-gawande-testing-ground/?utm_source=Sailthru&utm_medium=email&utm_campaign=Newsletter%20Weekly%20Roundup:%20Healthcare%20Dive%2006-30-2018&utm_term=Healthcare%20Dive%20Weekender
(C) As Atul Gawande steps into a risky health CEO role, here are five challenges he faces, by CASEY ROSS, https://www.statnews.com/2018/07/09/atul-gawande-health-ceo-risks/
(D) 9 lesser known things about Dr. Atul Gawande, by Emily Rappleye, https://www.beckershospitalreview.com/hospital-management-administration/9-lesser-known-things-about-atul-gawande.html
(E) CEO Gawande’s first task: a road trip to hear firsthand about workers’ health challenges, By CASEY ROSS, https://www.statnews.com/2018/07/19/atul-gawande-ceo-listening-tour/