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

Jobs/Sculley and later Tim Cook situation comes to mind - Sculley had the whole CEO experience but look how that turned out and look at how Tim Cook took over operations part which Jobs had no interest or knowledge of and made it work so well. If they had Tim Cook as the CEO pre-iphone days - I am not sure if we would have seen the iPhone.

Consider the alternative: the CEO is a professional “manager” who can run the shop, but may (or more likely, may not) understand what the shop is all about. Then who drives vision and strategy? Someone lower in the hierarchy can’t get himself taken seriously enough (sorry, but that’s just the nature of hierarchies). He (Atul) could be made the exec president or something of that sort, but an organization like this one needs a more hands-on visionary, who can corral the staff, while leaving the administrative and political minutiae to a trusted lieutenant.

Funny. Morning exercises were are part of Japanese corporate culture for a generation. In many European countries employers are expected to support employee fitness goals. My job (military) mandates that we all be given five one-hour periods each week to exercise. Not weekends, during the work day. It is totally normal for someone to go from meeting to the gym and back again during the day. Our civilian employees participate in this too, although they aren't tested.

I think it totally reasonable for any large company to make exercise part of their corporate culture, particularly in the US where employers are so involved in health care. Anyone laughing such ideas out of the room needs to broaden their horizons.

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.

I point that out so you fully understand that when I say a doctor:healthcare QI as a bees:entomologist, I say that from both sides of the fence. It gives you some more insight in your little slice, but that’s it. And it’s just your little slice: I am not a surgeon, so I know jack shit about their operational processes. I do know from a recent kerfuffle in my hospital that even the surgeons don’t know much about how the OR department books rooms and schedules procedures. They certainly don’t have insight into the parts of the hospital that -aren’t- a core part of their job. Being a physician is an important window into how hc systems and organizations work, but it’s a tiny one. It doesn’t qualify one for hc QI by itself.

As to his cv, by all means, check out where he’s first author, where he’s “contributing guy with a name” (second to last), how many of them are editorials or round tables, how many of them are endocrine surgery, etc. Actual first author, non editorial healthcare ops papers are thin on the ground.

This feels like nitpicking. The guy is intelligent and accomplished, beyond question. But what he -isn’t- is a hc innovator just because he -writes- about the hc system and innovations therein. I’ve never seen him write on a topic that wasn’t already hot shit in the field for two decades; I’ve never seen him present the pile of conflicting data for his preferred solutions (eg, the Checklist Manifesto chose to elide how many hospitals implemented checklists to no improvement, despite plenty of the results being published before his book.)

I agree with parent comment -- there is a difference between being the person/people who came up with brilliant ideas and being the person who brought them to the masses in a pithy, cogent and engaging manner.

One might even make the argument that the latter task is relatively more important than the former for people in high-visibility figurehead type positions such as CEO of a massively ambitious new healthcare venture.

The "Gladwell for healthcare" comparison is a good one, and I say that as someone who has enjoyed reading Gawande's books.

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 a second wave. That’s not really visible to the lay reader.

>I'd certainly push back against the comparison to Malcolm Gladwell -- atul gawande is a practicing surgeon and professor at one of the most well respected hospitals in the world. If Malcolm Gladwell wrote about the 10,000 hour rule from his personal experience becoming, say, a chess grand master through 10,000 hours of practice, then the comparison would be more apt.

AG does not write about healthcare QI from the perspective of someone that works in ops or hc QI. It’s a real profession, and one he hasn’t practiced.

He writes about macroeconomics and corporate management (and if that seems wildly dissimilar to you, you have some appreciation of how far afield he pokes his nose) from the perspective of the factory worker. And when he at least stuck to his area of medical expertise, at least he had some subject matter expertise to inform his perspective. He’s expanded outward from there, with neither academic nor medical expertise on the topic. There’s nothing terrible about that, but he’s -not- 10k hr guy writing about 10k hrs. He’s a guy with a passion, who has read up a bunch on topics he’s passionate about, and written about them well. They have some small overlap with his profession (diagnosing endocrine disorders; cutting out thyroids, Not reorganizing hc delivery processes), which adds some insight. Yeah, he’s slightly better than MG, but not by an awful lot.

I have an untested hypothesis that one of the best ways to get physician mindshare is actually through think pieces in publications like the new yorker or new york times -- just the kind of articles Atul Gawande writes. The physicians that I know read these articles much more actively than they use linked in (most dont) or any other online community

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 because I’m that good”. In practice it doesn’t get applied because humans have ego and incentives get misaligned. It’s not actually that beneficial to reduce complications in surgery for the hospital as long as the patient is insured. And it’s not that beneficial for the insurance company to reduce costs because fundamentally as long as the insurance company can accurately predict how much costs will rise next year, they still make money. They just need to know how much premiums will go up.

Healthcare is full of great ideas and ways to make things better, but they often just don’t get implemented because the whole system is so poorly set up. I don’t see any evidence that Gawande for all his talents has a good approach or the expertise to break through all that.

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.