Earlier quoted context omitted.
Considering how f...ed up the American health system is on all levels I am fine with giving an outsider a chance. Gawande appears to be a reasonable guy and a good communicator. Even if he fails, nothing is lost because the system can't get worse.
This is exactly the same logic I heard used by many people voting for Trump. The truth is that there usually is a real downside from failure, even if it feels like our huge systems are as bad as they can get. In other words, while we do have an expensive system with worse outcomes than peer nations, at least right now we have healthcare being delivered at a first-world level, and we shouldn't take that for granted.
Surgeon Atul Gawande selected as CEO of new health care company from Amazon
71–80 of 146 posts
Re: Surgeon Atul Gawande selected as CEO of new health care company from Amazon
#72Earlier quoted context omitted.
Healthcare/biotech companies typically have a CMO position (chief medical officer) which carries a lot of weight. I'm surprised that's not the way they went with a surgeon.
In an insurance context a CMO would be someone orchestrating coverage policy rather than serving in an advisory capacity iirc. It's a different role for the title.
Re: Surgeon Atul Gawande selected as CEO of new health care company from Amazon
#73Earlier quoted context omitted.
Care to share what you found?
Sure. 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/ 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, h…
Re: Surgeon Atul Gawande selected as CEO of new health care company from Amazon
#74Earlier quoted context omitted.
This is exactly the same logic I heard used by many people voting for Trump. The truth is that there usually is a real downside from failure, even if it feels like our huge systems are as bad as they can get. In other words, while we do have an expensive system with worse outcomes than peer nations, at least right now we have healthcare being delivered at a first-world level, and we shouldn't take that for granted.
Well... uhh... this guy is not in charge of everyone's healthcare - he's in charge of a rather small group of companies instead. The consequences of failure here are not exactly analogous to your example. 330 million people are not going to impacted by whatever is considered a failure here.
The three companies [Amazon, JPMorgan, and Berkshire Hathaway] are self-insured employers, which means that when you're an employee going to a doctor's appointment, your employer, rather than a health insurer, is ultimately footing the bill for the MRI exam you receive... "We're already the insurance company, we're already making these decisions, and we simply want do a better job," - JPMorgan CEO Jamie Dimon http://www.businessinsider.com/amazon-jpmorgan-and-berkshire...
Surely, that should be manageable for an insider like Atul Gawande. And it is nowhere same as wrangling with legacy American healthcare system (where one is dealing with insurance companies among others).
Re: Surgeon Atul Gawande selected as CEO of new health care company from Amazon
#75Atul 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 an…
Atul might be the Trump like shock that the establishment of medical sector needs.
Of course at the end of the day CEO appointments are gambles and I see this as one too.
Re: Surgeon Atul Gawande selected as CEO of new health care company from Amazon
#76Earlier quoted context omitted.
I took a short walk down this idea of a vertically integrated system, essentially building the system as a research lab (something like NIH building 10), including approaching some senior people. I sort of wonder if maybe they modified their expectations for the venture after a search revealed that experienced CEOs weren't interested. You have to address questions like "Where are you going to get physicians? Nurses?…
I've also done some work trying to get people to implement different models of care outside of the traditional institutions, and getting physicians on board is just a big hurdle. As a group they are pretty conservative and risk averse, hugely busy, and there aren't a lot of places where they congregate, online or otherwise, so outreach is a bit of hand to hand combat. I have an untested hypothesis that one of the bes…
Dirty secret of healthcare: “efficiency” translates to “I make less money” for almost everyone in the system, very much including doctors. All will protest and justify their cost, all will make good arguments in the individual case. In the aggregate though, we pay people too much (among many many other issues).
[1] https://jamanetwork.com/journals/jama/article-abstract/26746...
Re: Surgeon Atul Gawande selected as CEO of new health care company from Amazon
#77Earlier quoted context omitted.
Jeff bezos mentioned they were looking for someone with expert knowledge, a beginner's mind, and a long-term perspective. Any leader of a current large healthcare organization would probably fail the 2nd and potentially 3rd criteria. In light of these criteria, the choice of Atul Gawande makes sense
That’s actually my point, I would argue Gawande doesn’t have expert knowledge. Being an expert surgeon is a very different skill set than an expert in healthcare delivery and management. Let’s take the checklist manifesto, a fantastic idea that unfortunately isn’t as widely applied as it should be. Why? Because if you ask most surgeons they’ll say, “yeah it’s a great idea, I do it already/I don’t need to do it though…
Re: Surgeon Atul Gawande selected as CEO of new health care company from Amazon
#78BWH 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 consecuti…
Re: Surgeon Atul Gawande selected as CEO of new health care company from Amazon
#79Earlier quoted context omitted.
Jeff bezos mentioned they were looking for someone with expert knowledge, a beginner's mind, and a long-term perspective. Any leader of a current large healthcare organization would probably fail the 2nd and potentially 3rd criteria. In light of these criteria, the choice of Atul Gawande makes sense
That’s actually my point, I would argue Gawande doesn’t have expert knowledge. Being an expert surgeon is a very different skill set than an expert in healthcare delivery and management. Let’s take the checklist manifesto, a fantastic idea that unfortunately isn’t as widely applied as it should be. Why? Because if you ask most surgeons they’ll say, “yeah it’s a great idea, I do it already/I don’t need to do it though…
Re: Surgeon Atul Gawande selected as CEO of new health care company from Amazon
#80I 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/
The 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