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Dr. Atul Gawande has experienced many first days throughout his career. Monday may be his biggest yet.
Gawande is slated to formally start as chief executive officer of the joint health-care venture between J.P. Morgan, Amazon and Berkshire Hathaway. The trio's CEOs, Jamie Dimon, Jeff Bezos and Warren Buffett, announced in January that they would form a new nonprofit company aimed at lowering health-care costs for their combined roughly 1.2 million employees and possibly one day all Americans.
Gawande has written and spoken extensively about inefficiencies in the current system. He will now be tasked with finding ways to fix them.
It's a daunting assignment, but colleagues say Buffett, Bezos and Dimon chose the right person. They describe him as someone who's brilliant yet modest. They say he genuinely wants to understand people and improve the world around him.
"I can't think of anybody who'd be better. I don't know of anybody who'd be better," said Dr. Arnold Epstein of Harvard's T.H. Chan School of Public Health. Epstein is chair of the department of health policy and management at the school of public health, where Gawande teaches.
Gawande, 52, is a professor in the department of health policy and management at the school of public health and the Samuel O. Thier Professor of Surgery at Harvard Medical School. He's a general and endocrine surgeon at Brigham and Women's Hospital in Boston, where the new company will be based.
Dr. Monica Bertagnolli, chief of the division of surgical oncology at Dana-Farber/Brigham and Women’s Cancer Center, has known Gawande for nearly two decades. She taught him when he was training to become a surgeon and immediately saw his interest in people, his desire to understand their points of view and his ability to communicate them.
"No matter what he's doing, whether being an educator, a surgeon or running a program, he pays attention in everything he does, who he's there to help and serve. That really shines through everything he does. It's about the people and what they need," said Bertagnolli, who's now one of Gawande's colleagues at Brigham and Women's Hospital and Harvard.
Some know Gawande best for his writing. He's penned four best-selling books: "Complications," "Better," "The Checklist Manifesto" and "Being Mortal." He has also been a staff writer at The New Yorker since 1998.
Gawande's 2009 New Yorker article "The Cost Conundrum" examined why some health-care markets are more expensive than others. He focused on McAllen, Texas, where he found "across-the-board overuse of medicine" was the primary cause of it being one of the most expensive health-care markets at the time.
Buffett's longtime investing partner Charlie Munger gave Gawande $20,000 after reading the piece because it was "so useful socially," Buffett in 2010. Gawande told STAT News last month that the article "opened the door" for him being named to lead the new venture.
In the decade since he wrote the article, Gawande has continued tracking how unnecessary medical care hurts patients physically and financially.
Sara Bleich, a professor of public health policy at Harvard, said the story shows Gawande's level of interest and curiosity in the world.
"I think he's a very good, curious person," she said. "More so than others."
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.