Critics have argued while Gawande has written extensively about problems plaguing health care, he hasn't done much to fix them. His new role will likely require running a business and negotiating with other players in the health-care system, including drugmakers and pharmacy benefits managers.
“Communication in both directions is pretty important,” said Dr. Bob Wachter, chair of the department of medicine at the University of California, San Francisco. “You have to be able to listen to what doctors, nurses and CEOs say. You have to communicate what (doctors are) trying to do and why. Nobody in the world is better at both those things than he is. This is a different set of challenges when it comes to communication, so I would trade his ability to do those things than the ability to navigate around a big spreadsheet.”
He'll have the backing of three legendary CEOs. He's also founded Lifebox, a nongovernmental organization focused on making surgery safer, and Ariadne Labs, an organization focused on innovation in health systems.
Gawande founded Ariadne Labs in 2012. The partnership between Harvard and Brigham and Women's Hospital is best known for its surgical safety checklist, which Gawande and what would become the Ariadne team developed with the World Health Organization in 2008.
Implementing the list was associated with declines in the hospitals' death rates and inpatient complications, the study found, according to research published in the New England Journal of Medicine.
Gawande will remain executive director while Ariadne Labs searches for his successor, he said in an email to Harvard faculty announcing his new role. He will then transition to chairman and continue his work as a surgeon and professor. He also plans to continue writing, including for The New Yorker.
"I'm delighted for him and delighted for our field," said Bertagnolli, Gawande's former professor and now colleague. "It's very clear that health care needs some new solutions to the problems that we face. For someone who is such an out of the box, strategic thinker and is also so grounded in what we need to take care of patients, I couldn't be more delighted to see him have this kind of vehicle to see a vision through."
Gawande's task isn't easy. Health-care spending has ballooned to 18 percent of the nation's gross domestic product and is expected to reach 20 percent by 2025. Skeptics question whether the new venture will be able to do what so many others have tried, and failed, to do.
In his email to Harvard colleagues, Gawande recognized the challenge — and the opportunity.
"This new health care organization represents one of the most promising opportunities to accelerate improvement of U.S. health care delivery," he wrote. "The work will be difficult and take time, but it must be done. And we will have the opportunity to do it together, with many exceptional organizations, including Ariadne Labs. My vision is to develop high-impact collaborations across the health care sector."
Everyone will be watching to see whether this initiative will be different.