The Right Atul For The Job (Why Atul Gawande Should Matter To You, Part 1)

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For those who don’t know, Amazon, Berkshire Hathaway, and JPMorgan Chase have come together on a health care venture that has health tech entrepreneurs watching very closely. Part of the interest is, let’s be honest, a result of the sheer capital potentially involved, and part of it is that the details of the project remain largely a mystery. But on Wednesday, Atul Gawande was named its new CEO and if you haven’t yet heard that name, here’s why it matters:


A renowned surgeon and New Yorker health policy contributor, Gawande has made his name focusing on simple, self-professed “unsexy” solutions to health care needs. In his newest book, The Checklist Manifesto (currently on eight bestseller lists), he looks to other high-risk industries like aviation to find opportunities for improvement where trained specialists and state of the art technology already exist. Gawande finds that even among highly specialized work, perhaps especially so, implementing a checklist allows for pause points to reassess that everything has been completed correctly before moving on to the next step. And while it might sound obvious, when his checklist was implemented in eight hospitals in as many countries, all eight saw drastic reductions in both complications and deaths in surgery.


In the spirit of Gawande’s emphasis on health care operating as an efficient system where many voices must find a consensus in order to address health needs, we have gathered our top five ideas from his extensive work that we hope he brings to the new company (and hopefully as a result, the nation’s healthcare landscape at large):


Pit Crews – We tend to think of the physician as the sole authority on diagnosing and treating patients, the specialist most of all. We romanticize the autonomy and self-sufficiency of a world-renowned surgeon as the highest form of medical care professional the way we romanticize cowboys in the Wild West. But Gawande, a well-revered Harvard pedigree doctor himself, tells us that the cowboy’s ego and hyper-competitiveness are easily beaten by the pit crew’s evidence based and consensus decision-making. In his essay “Cowboys and Pit Crews in the New Yorker, Gawande states that “medicine’s complexity has exceeded our individual capabilities as doctors.” This extends beyond just hospitals to the government agencies and companies that provide health data and analytics. Group thinking, decision-making, and treatments lead to better care for patients.


Data – Though they seem simple, checklists don’t come out of thin air. It takes extensive research and data compilation to even begin the process of learning what steps are necessary, in which order, and where mistakes are likely to happen before you arrive at error prevention. Data supported decision-making is a foundational belief of those of us drawn to the sciences, yet it has somehow lost its prominence in our thinking, regulation, and legislation. Gawande would have us return to our roots; looking always to research and data as a leaping-off point, rather than a final step to confirm our beliefs. “Medicine has become the art of managing extreme complexity” he writes in The Checklist Manifesto, “and a test of whether such complexity can, in fact, be humanly mastered.” Not by any one individual or any isolated perspective maybe, but perhaps through the relentless seeking of data to anchor our knowledge, innovations beyond what we thought possible can be achieved.


Incremental Health Care – Gawande stresses that high cost does not equal best care. In his New Yorker article “The Heroism of Incremental Care,” Gawande chronicles his own change of heart regarding the impact that rescue medicine versus regular maintenance and incremental diagnostics make in a person’s life. Surprisingly, though we often throw the bulk of our resources at surgeons, cardiologists, and the like, it is the primary care physician that makes the greatest difference in mortality rates and quality of life. Gawande admits his pull to the hero aspect of being a surgeon and rescue medicine, but asks us to reconsider which fields we most revere with our hearts and our funding, highlighting the nurses, nurse practitioners, primary care physicians, and general clinicians. And to Gawande, this isn’t a matter of opinion. “We can give up an antiquated set of priorities and shift our focus from rescue medicine to lifelong incremental care,” he states unilaterally, “[o]r we can leave millions of people to suffer and die from conditions that, increasingly, can be predicted and managed.”


Charisma – If it isn’t yet clear, Gawande has a way of taking a look at the most inscrutable, difficult to parse problems in healthcare and unraveling them into a clear, beautifully written essay that appeals to both the humanity and business aspects of health care. Chances are, if you’ve had an idea of how to improve the health care system, Gawande has said exactly what you thought, but more succinctly, with compelling narratives and vulnerable anecdotes to boot. With all the other expertise he has going for him, his written and oratory skill could be overlooked, but we would disagree! When health care discussions sometimes feel dead in the water before they even begin because of the varying opinions on what and how to fix, the massive amounts of data necessary, and the emotional charge from each of our individual experiences within the health care system, a little charisma can go a long way to getting everyone around the table.


DATA – Say it again for the people in the back! Data is vital, and without emphasis on it, none of the complex problems in healthcare can even begin to be addressed. As entrepreneurs in health and technology, it is important to base innovation in the data available and also to seek out new data – the more, the better! Only by collecting the full picture can we begin to zoom in to individual needs within the health care sphere. We hope admitted data champion Atul Gawande brings this issue to forefront; he is clearly one of the great health policy minds of this generation, and we are excited for what he comes up with next!


Now that we’re all better acquainted with Atul, stay tuned for our next blog, where we hash out what you should be doing in response to his appointment…

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