Surgeon Atul Gawande selected as CEO of new health care company from Amazon • Hacker News Board

Re: Surgeon Atul Gawande selected as CEO of new health care company from Amazon

#121

Post by tbg7504 » Wed, Jun 20, 2018, 8:12 PM UTC

refurb wrote: post #99

It'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!

Most 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.

Re: Surgeon Atul Gawande selected as CEO of new health care company from Amazon

#122

Post by sonnyblarney » Wed, Jun 20, 2018, 8:13 PM UTC

aaavl2821 wrote: post #57

qaq wrote: post #52

Earlier quoted context omitted.

I know appeal to authority is obviously a bad way to support an argument, but I would imagine one thing the most senior people at Amazon, Berkshire Hathaway and JPM are fairly decent @ is picking management talent. So if all 3 sides agreed on a pick I would imaging there was pretty compelling case.

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

Yes, but you still need someone with startupy hustle, and with a CEO mindset, as well as a knack for ops.

In light of this, I'm truly perplexed by this choice.

This is not a 'resarch organization' or something like 'doctors without borders' for whom this guy would be a great choice.

Living outside of 'revenue' and 'products/services' all of one's career makes this a difficult choice.

Re: Surgeon Atul Gawande selected as CEO of new health care company from Amazon

#123

Post by aaavl2821 » Wed, Jun 20, 2018, 8:40 PM UTC

sonnyblarney wrote: post #122

aaavl2821 wrote: post #57

Earlier 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

Yes, but you still need someone with startupy hustle, and with a CEO mindset, as well as a knack for ops. In light of this, I'm truly perplexed by this choice. This is not a 'resarch organization' or something like 'doctors without borders' for whom this guy would be a great choice. Living outside of 'revenue' and 'products/services' all of one's career makes this a difficult choice.

I think one of the reasons tech startups haven't made a bigger dent in healthcare / biotech is bc they overweight startup hustle and underweight experience and domain expertise. Better to walk towards the right target than run really fast to the wrong one, and in fields like healthcare you can't pivot as quickly once you realize you're going in the wrong direction

Basically all successful biotech CEOs are old, former big pharma execs or academics -- two fields not known for their hustle. And they can grow big, fast: look at CEOs of Juno, avexis, kite; those companies were bought for $9-12B cash just 5ish years post series a

The biggest health tech companies are Cerner and Epic. They were founded in the 1970s I think. Have avoided disruption bc they know the system. Many other successful health tech companies are founded by dyed in the wool industry veterans or doctors with a good understanding of the field who work 9-5

Plus Atul probably has some hustle. He became a best selling author while being a surgeon and prof at Harvard. Takes initiative to decide to write books and actually pull off getting them sold. He sure knows how to build an audience -- probably has a bigger audience than any health tech startup CEO

Re: Surgeon Atul Gawande selected as CEO of new health care company from Amazon

#124

Post by twblalock » Wed, Jun 20, 2018, 8:49 PM UTC

ggg9990 wrote: post #103

mkull wrote: post #87

Earlier quoted context omitted.

I 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.

Nah, the COO can’t really say “no” the way the CEO can to all the execs and their pet projects for their personal agenda.

Sure he can, if people know the CEO backs his decisions.

Re: Surgeon Atul Gawande selected as CEO of new health care company from Amazon

#125

Post by ibrault » Wed, Jun 20, 2018, 8:50 PM UTC

arkades wrote: post #38

entee wrote: post #12

Atul 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 Gawande is a brilliant person with interesting ideas on how to make healthcare more humane and robust No, he’s not. No offense to him, but he’s a -popularizer-. He takes various bits the HC quality improvement folks have been talking about / doing for years and writes (very articulate, engaging) articles that make it accessible to the wider community, including the wider medical community that normally isn’t in…

Slightly off topic, but I'm curious as to what your objection to Malcolm Gladwell is?

Re: Surgeon Atul Gawande selected as CEO of new health care company from Amazon

#126

Post by vqc » Wed, Jun 20, 2018, 8:56 PM UTC

r00fus wrote: post #108

arkades wrote: post #94

Earlier quoted context omitted.

> I don’t think his ideas are shallow or one dimensional, but I havent read all of his work. You wouldn’t. He adds depth through humanity, while eliding the pile of data that contradicts his points - data you have no reason to notice is missing. While the hc QI community was getting over checklists because of the number of studies showing it to be a largely ineffective intervention, he ignored the pile and kicked off…

> While the hc QI community was getting over checklists because of the number of studies showing it to be a largely ineffective intervention Do you have a cite for this?

This might be one

"Systematic review of safety checklists for use by medical care teams in acute hospital settings - limited evidence of effectiveness" (2011) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3176176/

Re: Surgeon Atul Gawande selected as CEO of new health care company from Amazon

#127

Post by lotsofpulp » Wed, Jun 20, 2018, 9:14 PM UTC

siculars wrote: post #114

entee wrote: post #76

Earlier quoted context omitted.

Another (darker) perspective: they don’t want to lose money. Healthcare in the US is expensive in no small part because we pay more for things (duh). One of those things is physician time. Primary care physicians in the US make $60K more a year than comparable nations [1]. Dirty secret of healthcare: “efficiency” translates to “I make less money” for almost everyone in the system, very much including doctors. All wil…

Physicians, and others, pay for their medical education in the US. How do physicians pay for their education in other countries or is it paid for them by their governments?

Also, the doctors I know basically give up their 20s and early 30s in the American system. But that might be due to existing doctors making sure supply stays low so their prices stay high, and so they can do that by making credentialing lengthy and difficult.

Re: Surgeon Atul Gawande selected as CEO of new health care company from Amazon

#128

Post by entee » Wed, Jun 20, 2018, 10:05 PM UTC

aaavl2821 wrote: post #104

entee wrote: post #69

Earlier quoted context omitted.

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…

Your point seems true regarding that particular article, though I dont think that is sufficient to demonstrate that he doesnt understand the system. As a surgeon, I'm sure he knows the barriers to adoption of such a tool, and being the head of a large buying consortium for health insurance (Amazon / berk / jpm) could give him the market power to "wag the dog" and push payers to implement such policies. But i agree th…

Your point is an excellent positive case for his appointment :).

I fully agree with you on monopolies and hot spotters. The monopolies are a pernicious issue that's incredibly hard to solve, and targeting hot spotters is not likely to be the silver bullet people hope it will be.

I hope he succeeds given his perspective, I'm just skeptical that he can given the scale and structure of the problem. In particular the monopolies issue seems utterly intractable. Maybe some combination of remote care and creating vertically integrated treatment centers can help? I don't know, healthcare is really hard. I just hope this isn't a flash/vision over nitty gritty execution appointment.

Re: Surgeon Atul Gawande selected as CEO of new health care company from Amazon

#129

Post by tim333 » Wed, Jun 20, 2018, 10:13 PM UTC

entee wrote: post #69

aaavl2821 wrote: post #57

Earlier 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…

>doesn’t have expert knowledge ... very different skill set than an expert in healthcare delivery and management.

He's kind of celebrated for an article he wrote in the New Yorker on healthcare delivery and management. (see 'This magazine article saved $500M in unnecessary Rx spending' https://www.cnbc.com/2015/05/08/this-magazine-article-saved-...)

It impressed Munger, Buffett's partner sufficiently that he sent a cheque for $20,000 to Gawande at the time as a gift without knowing the guy. https://www.cnbc.com/2018/06/20/charlie-munger-once-wrote-at...

Re: Surgeon Atul Gawande selected as CEO of new health care company from Amazon

#130

Post by debt » Wed, Jun 20, 2018, 10:18 PM UTC

entee wrote: post #12

Atul 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…

"Unless the plan is to create a brand new completely vertically integrated system"

Judging by the companies involved, this is most likely the plan. Whatever they create will like cause the existing system change to it and not the other way around.