17/10/2020 Atul Gawande, a surgeon injecting humanity into US healthcare | Financial Times

Opinion Person in the News

Atul Gawande, a surgeon injecting humanity into US healthcare
He has been chosen to lead an Amazon venture that may reform a $3tn industry

ANJANA AHUJA

Anjana Ahuja JUNE 22 2018

In 2009, Atul Gawande received a surprise cheque for $20,000. It came not from
The New Yorker, the magazine for which the 52-year-old Boston-based doctor has
been a staff writer since 1998, or from a thankful patient, but from an executive in
Warren Buffett’s inner circle.

The money was a token of gratitude for an article entitled “The Cost Conundrum”,
an analysis of why ballooning healthcare costs in the US were not matched by
commensurate gains. Dr Gawande, an endocrinologist and surgeon at Brigham
and Women’s Hospital in Boston and a professor of public health at Harvard,
returned the cheque — only to receive two in return. The $40,000 went to charity.

This episode may have seeded the announcement that Dr Gawande is to be chief
executive of a non-profit venture funded jointly by Amazon, Berkshire Hathaway
and JPMorgan Chase, formed to address the health of their combined million-plus
workforce.

“I have devoted my public health career to building scalable solutions for better
healthcare delivery,” Dr Gawande said last week. “Now I have the backing of these
remarkable organisations to pursue this mission with even greater impact . . . This
work will take time but must be done. The system is broken, and better is
possible.”
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Other than boosting employee health and cutting costs, the prescription for the as-
yet-unnamed Boston venture is unclear. But the bloated $3tn US healthcare
industry is seen as ripe for the scalpel. Dr Gawande — who has written four
bestselling books on medicine, founded projects to improve health in developing
countries, and received a MacArthur Foundation “genius” award — will now have a
generously funded test bed to think differently. The involvement of Amazon
suggests technological disruption; bricks-and-mortar hospitals seem, literally, an
outmoded operating system in a digitised world.

It is an unexpected direction for the doctor who was tipped to be surgeon-general

in a Hillary Clinton administration. “I don’t think it’s excessive to call him our
most distinguished living doctor,” says Andrew Franklin, a friend and the founder
of Profile Books, which publishes his works in the UK.

“He has a real sense of the power of medicine to improve the world. And he’s
become fantastically successful without becoming obnoxious. I don’t have many
heroes but Atul is one of them.”

Born in 1965 in New York City to immigrant Indian doctors, the family later moved
to rural Ohio. His father, Atmaram, was a noted urologist, his mother, Sushila, a
paediatrician. The couple supported philanthropic causes in the US and India. The
young Atul resisted following in their footsteps, studying political science and
biology at Stanford (his sister Meeta became a lawyer) and volunteering in
Democrat circles. A Rhodes scholarship whisked him to Balliol College, Oxford, for
a masters in philosophy, politics and economics.

But the call of medicine proved too strong. By the mid-1990s, Dr Gawande had
secured his medical degree from Harvard and dabbled in health policy for Bill
Clinton’s presidential campaign. He had also met Kathleen Hobson, a literature
graduate whom he later married. The couple have three children, one born with a
heart condition, which has afforded him a view from the other side of the operating
table. Last year, he tweeted pointedly to his 252,000 followers that his son was one
of the uninsurables. His most recent book, Being Mortal , addressed ageing and
death, partly through the experience of watching his father succumb to cancer.

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17/10/2020 Atul Gawande, a surgeon injecting humanity into US healthcare | Financial Times

It was his friend Malcolm Gladwell who first persuaded him to write, initially for
the internet magazine Slate and later for The New Yorker. Dr Gawande quickly
garnered public acclaim and awards for elegant essays on public health and
medicine. Books expanded his reach: his first two, Complications and Better,
focused on his experiences as a surgeon and brought an aura of humility to a
profession known for its swagger. His third, The Checklist Manifesto, advocating a
policy usually associated with aviation safety, became a manual for medical reform.
Hospitals which took such basic steps as confirming a patient’s name before an
operation found their death rates nearly halved. Major surgical complications fell
by a third. The idea was taken up by the World Health Organization, for which he
became an ambassador.

Ara Darzi, the pioneering surgeon and advocate of National Health Service reform
in the UK, says Dr Gawande has “altered public and professional perceptions of the
culture of modern medicine”. One health professional described him as “confident
without being slick”.

He is also ferociously organised, slicing his diary into 10-minute segments; he

reportedly writes during the 45-minute turnround between operations. Running
things is not his métier. But Ashish Jha, director of Harvard’s Global Health
Institute, detects method in the managerial madness: “If they had a detailed
strategic plan, Atul would not be the guy to execute it. But they do have someone
with a broad vision . . . and as brilliant a communicator as you can get.”

When asked about screwing up, Dr Gawande said last year that he had failed at two
things: philosophy and songwriting. He was once in a rock band whose many
names included Thousands of Breaded Shrimp, and wrote dirges while abroad,
pining for his girlfriend. “The songs were terrible,” he recalled. But he still got the
girl.

The writer is a science commentator

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