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Surgeon Atul Gawande selected as CEO of new health care company from Amazon
- slantedview 8y agoImagine if these three companies used their political clout to push for single payer instead of setting up yet another insurance company.
- decebalus1 8y agoIf you're asking yourself why you're getting downvoted, it's because you committed blasphemy by saying s * * * * p * * * * in the USA.
- exolymph 8y agoI disagree — lots of HN denizens support a single-payer model. What's silly is thinking that Amazon et al could trivially push it through within a reasonable timeframe.
- ocdtrekkie 8y agoI don't know how to fix this title, but it reads at a glance as either: Atul Gawande is going to be the CEO of Amazon, or that "Amazon" is the name of a Berkshire healthcare company. EDIT: Thanks to the mods for the title fix, this is much better.
- collinf 8y agoLiterally just listened to his podcast he did with Freakonomics Radio yesterday. Definitely a great mind. For all of you developers/operations folks out there, I recommend reading his book The Checklist Manifesto. Every team can learn so much from that book about their everyday practices. We read it at our company book club, and began taking checklists and documentation much more seriously which I attribute too much better productivity, operations and less siloed dev.
- schnevets 8y agoI was just about to mention that podcast episode! He clearly has a good, realistic grasp of what can be done to improve healthcare outside of the political mudpit. I was skeptical when this company was announced, but I am now extremely optimistic. http://freakonomics.com/podcast/atul-gawande/ http://freakonomics.com/podcast/atul-gawande/
- nelsonic 8y agoSuch Great Choice! Atul Gawande is the definition of integrity. On this basis alone I would subscribe as a individual or company co-founder. Bravo!
- amarant 8y agothis title could be improved, at first glance it seems to imply he will be CEO of Amazon AND some healthcare company from Berkshire. that's not the case.
- glenscott1 8y agoI can thoroughly recommend reading Atul Gawande's "Checklist Manifesto". The premise, on the face of it, is mundane, but the stories that back up the claims are thoroughly enjoyable to read. http://atulgawande.com/book/the-checklist-manifesto/ http://atulgawande.com/book/the-checklist-manifesto/
- TeMPOraL 8y agoThanks for bringing this up! The name of the CEO didn't ring any bells for me until your comment. I've read the book and loved it; I second the recommendation.
- hurryharry 8y agoCame here to say the same - book is an excellent read applicable across many professions.
- Tomte 8y agoThe book is good, but the article it‘s based on is better, because there‘s simply not enough material for a whole book, so it feels a bit forced. https://www.newyorker.com/magazine/2007/12/10/the-checklist https://www.newyorker.com/magazine/2007/12/10/the-checklist
- sp332 8y ago"The new company will be based in Boston." Just wondering if there's a big regulatory benefit to being in Massachusetts.
- aaavl2821 8y agoThis is the kind of healthcare CEO most health tech startups should have -- someone who lives and breathes the system, intimately knows it's flaws but still has the vision and desire to change it. That is the rare and valuable skill in healthcare -- even more rare than engineering or operations skill Rushika Fernandopulle, the healthcare CEO I most admire, fits this profile
- baus 8y agoThis gives me hope for the US health care system. Gawande’s ‘Being Mortal’ really helped me understand what was happening when my dad was dying. Highly recommend it
- entee 8y agoAtul Gawande is a brilliant person with interesting ideas on how to make healthcare more humane and robust. This is still probably a terrible choice of CEO. To my knowledge he has never run a large organization or dealt directly with the complex backend of the healthcare system. The was healthcare is delivered and paid for is full of independent, semi monopolistic players that have often conflicting incentives. Oh and lets not forget that we have 50 states and 50 different sets of regulations. Unless the plan is to create a brand new completely vertically integrated system, you’re gonna have to deal with the existing infrastructure, and I’d be much more confident in success if the person leading that effort had experience there. Having worked with many physicians and insurance companies, I can say from experience those skill sets are not the same. Even if the idea is to be vertically integrated, someone like the CEO of the Mayo Clinic or Kaiser would have been a better choice.
- pinewurst 8y agoHe's certainly a mismatch for the likes of Amazon and I'll bet won't have a long tenure. Reading about their worker healthcare ("AmCare"), one pictures a rusty tin of stained bandages. And a permanent mark on one's employee record if the tin is opened.
- baus 8y agoI’d say hire that person as the COO. This will be a big organization. I think the person at the top needs to have a strong ideals about the direction of the organization
- rattray 8y agoAgreed – there's so much complexity that wrangling it is it's own effort, worthy of delegation to a supremely skilled and experienced operator. If _all_ this company did was wrangle the complexity of the healthcare system, however, they wouldn't be a step function better than anything else. For the deeper, more radical changes, you need a visionary at the helm. Of course, Atul will need to be able to effectively recruit & work with a stellar team to fill the gaps you mention.
- EpicEng 8y ago
- Thriptic 8y agoI love Gawande; he's an amazing author and very thoughtful, systematic physician. That being said, to my knowledge he has never actually run anything before or operated on the back end of healthcare, so it seems like sort of a strange choice for an org this size and of this type. Additionally, his (publicly stated) thinking seems to primarily revolve around systematizing routine practice to reliably increase outcomes for the majority of patients (ie what he espouses in Checklist Manifesto). While this is certainly important, routine patients are not responsible for most health care spend, edge case patients are. A tiny minority of very sick people account for a majority of health care spend, so I would argue that cost recovery should center around creative management of these patients rather than more systematic management of routine care, and the org should really be led by someone whose thinking centers on that.
- tonyedgecombe 8y agoTo be fair the people running existing health care organisations are all experienced at creating the sort of company they want to avoid.
- 40acres 8y agoSolid choice. He's a brilliant guy and obviously has deep knowledge of current flaws in out system.
- slantedview 8y agoFragmentation - such as the creation of this company - is the primary flaw in the system. His leading that company stands in opposition to the ability to fix healthcare.
- aaavl2821 8y agoThis is a separate debate, but id argue that consolidation, not fragmentation, is the current primary flaw in the system It's a zero sum consolidation arms race between payers and providers with patients and physicians as pawns
- yanslookup 8y agoCurious, what are the n-order effects of large corporations reducing the cost of providing health insurance for their employees? My wages won't go up (probably), their profits will go up but I'm sure many other things happen in the middle. How will this affect taxes at the fed, state, local level? Will one level see an increase/decrease in taxes collected? etc.
- mFixman 8y agoI've read most of Atul Gawande's books about the medical industry (Better, Complications, and The Checklist Manifesto) and I found the three of them extremely relevant to my career as a computer scientist. The latter book is by far his most famous, but IMHO the other two are much better. This is a bold choice by Amazon, but it seems like a good idea even if it's just for name recognition.
- projectramo 8y agoWhen I read the checklist manifesto I thought it was going to change my life. It didn't because I didn't put it into effect. Then I thought it would be great if software did the work for me, including communal checklists that people can share with me. (Got a new car, here is a checklist template. Got a new house? Here is the checklist template? Is it an investment property, use this checklist. Oh, that is good for Florida, but in Texas, use this one.) I found some software that is sort of close but nothing quite there. Edit: Atul Gawande wrote the book so it is sort of tangentially related. I could make it more relevant by explaining how his checklists make him a general purpose leader or something, but I can't bring myself to do it.
- miketery 8y agoCare to share what you found?
- projectramo 8y agoSure. Well every to-do app has most of the functionality you need (Wunderlist is the one I like the best). They have annual reminders so you can put a checklist for taxes or something. BJ Novak has https://li.st/bjnovak/ https://li.st/bjnovak/ which is a general list sharing app. It has the social component that I think would be very useful applied to to-do lists. Finally, there are ready made list apps which help you maintain your home, health, car, kids, wealth etc. I wish there was a social market place like li.st for apps like Wunderlist with multiple lists to choose from.
- orky56 8y agoMulled this idea for quite awhile as the consumer version of an enterprise app I built. PM me if you'd like to chat more on it!
- selimthegrim 8y agoI used Asana when I had a huge trip to plan for and had checklists on top of checklists
- 8y ago
- JacobDotVI 8y agoIf you want to learn a little more about how Atul Gawande looks at the healthcare system read Being Mortal. IMHO it's more relevant than Checklist Manifesto, esp. wrt what Amazon could do here: https://www.amazon.com/Being-Mortal-Medicine-What-Matters/dp/1250076226/ref=sr_1_1?s=books&ie=UTF8&qid=1529507999&sr=1-1&keywords=atoll+gawande+being+mortal https://www.amazon.com/Being-Mortal-Medicine-What-Matters/dp... While Checklist Manifesto is about operational efficiency and quality, Being Mortal is about asking if we're doing the right things in the first place.
- jaredhansen 8y agoTyler Cowen's conversation with Mr Gawande[1] was well worth the time. I don't know enough about him or the new company's plans to speculate on how this will all work out (although: neither does anyone else in this thread), but he's clearly a highly intelligent and thoughtful person with deep domain expertise. I certainly wouldn't bet against. [1] https://medium.com/conversations-with-tyler/atul-gawande-checklist-books-tyler-cowen-d8268b8dfe53 https://medium.com/conversations-with-tyler/atul-gawande-che...
- tbg7504 8y agoBWH culture is crumbling so I won't blame him for seeking other opportunities. However, this is an odd/weak selection where I believe Amazon-Berkshire-Chase will regret. Toby Crosgrove, former Cleveland Clinic CEO, would have been a well-qualified candidate and better choice. He has over 10+ years of leading a highly complex AMC and elevating the organization into the top 3 hospitals in the country for many consecutive years. This man can get things done via transformative, sustainable, and systematic changes. Alternatively, the CEO of Iora Health would have been a good choice too. Let's pause and compare performaces and outcome of between Cleveland Clinic under Crosgrove and Iora Health under their leader, and Adrianes lab under Atul. The result is clear. Atul doesn't have the experience only the Harvard brand. Being a CEO is different from being a professor, surgeon, philosopher, or executive director at the Adrianes Lab. In those roles and physician-led environment where MDs are treated like kings, the medical directors can put in 5-10% of their time with the expertise of administrators, interns, staffs and get away with having the breadth but little depth and claiming to be a SME. Atul seems like a good storyteller and highly intelligent physician, but he is absolutely an individual contributor. Frankly, Boston is full of highly intelligent and innovative people like Atul; the CEO of this venture should have more experience or at least specializes in one of the three verticals. Atul would have been a better executive advisor. Concerns: - He stated not wanting to give up his privileges of practicing at BWH and professorship at Harvard meaning he can't be fully committed to leading this new organization. This is not an academic medical center environment where a physician can have multiple administrative titles and not put in the hours and work. - Atul's fame is credited to his publication, but also from the prestige of Harvard's affiliations. He knows this and is trying to strategic about not giving that up, but I would hope he realize that truly effective leaders know they can't do everything. Most of those innovator physicians stretch themselves too thin and get their hands into too many pots, making them ineffective. If he's serious, then he needs to commit and prioritize. IMO, extreme network/lip service must have been invloved in his pursuit or the new venture and company is only buying his fame, reputation, and brand for marketing purposes.
- xxpor 8y agoDidn't Cosgrove retire? Why would he be interested?
- deleted 8y ago[deleted]
- JoshTko 8y agoThis is the type of topic where I feel that HN community tends to not provide valuable insight as it's outside of the community's collective expertise. How many individuals here have hired SVP+ level employees and how would that compare to the collective experience of Bezos, Buffet, and Dimon?
- creaghpatr 8y agoBezos, Buffet, and Dimon are unfortunately not available today to discuss this topic in the HN forum so you're stuck debating the pros and cons with us [fellow?] peasants, sorry.
- codeisawesome 8y agoOff topic sorry, but this is such a British response. Funny.
- ggg9990 8y agoOuch. This is an incredible man who is a bad choice of CEO. CEO is fundamentally an execution-oriented, anti-creative role. Bezos know this and it implies that 1) He’s going to CEO this himself 2) He wants this intiative to fail
- mkull 8y agoI think you are confusing CEO with COO. CEO typically is providing vision, mission & strategic direction while the executive team he builds is more execution oriented.
- momentmaker 8y agoHad a conversation with someone that had a speculation that the recent departure of Jonathan Bush of athenahealth because of Elliot Management might get him appointed to this CEO position but I guess that didn't happen.
- refurb 8y agoIt's interesting reading the comments here. People with no background (I assume) in healthcare describe the guy as "brilliant" and "the perfect choice". People with years of experience in healthcare question think he's a poor pick and just a famous name. It's amazing what a good public relations strategy can do for someone!
- karl11 8y agoPeople with years of experience in healthcare are invested in the status quo.
- WhompingWindows 8y agoThis is a low-effort and mostly irrelevant argument. Who isn't invested in the status quo? Everyone has a stake in their current profession. What sets apart those in healthcare, especially someone like a surgeon, is their concurrent passion for science/biology and their desire to heal others. IMO, the parent comment was simply remarking that those with EXPERIENCE in the field have a very different set of memories/recollections about healthcare, not to mention a lot of domain-specific knowledge, that those outside do not have. Those of us who have worked in healthcare for years, as I have, have a MUCH more intimate understanding of its vast complexities than a lay-person could. I think that's entirely reasonable and your comment assigns a negative connotation to people who are largely doing noble and important work.
- refurb 8y agoThat’s Silicon Valley speak. People with actual experience on how something works and have practical ideas on how to make it better as passed over by people with better PR agencies.
- tbg7504 8y agoMost accurate observation and comment on this topic! With 10+ years of healthcare experience including Brigham and Women's hospital many years ago, he's a good writer, storyteller, but truly is just a famous name that Amazon-Chase-Berkshire venture wants. Without the Harvard brand, his work, while good, wouldn't be that highly praised and worshipped. There are better visionary physicians out there. My main takeaway is: being a good storyteller or facilitator on innovation does not make you any more innovative without the experience to support it. However, it can significantly elevate your personal brand beyond your qualificiations and apparently lure wealthy people to invest in you.
- conorh 8y agoHe seems like a very smart guy and an excellent communicator - I wonder if he'll be able to step up and make this role work. I will be rooting for him because the industry needs some players with deep pockets to step in and innovate. On a side note I find it funny in a sort of inside baseball way that his description of an operation that he does, that he describes in detail and holds up as an example, drives my surgeon wife up the wall because it is not great (she does a lot more of them).
- u1234567 8y agoi found this two blogs http://mawazo.tk http://mawazo.tk and htttp//cnn.com
- toufique 8y agoGreat choice.
- tootie 8y agoHe's written a lot for the New Yorker is very intelligent and thoughtful. No idea how he'll adjust to being an executive of a corporation, but I think that is a risk worth taking. It sends a message that they will be patient-first and strongly evidence-based. https://www.newyorker.com/contributors/atul-gawande https://www.newyorker.com/contributors/atul-gawande
- kapauldo 8y agoTerrible hire.