SAN DIEGO—Within the first 30 seconds of taking the stage, Atul Gawande, M.D., acknowledged his presentation about end-of-life care would “take on some greater significance” given the previous day’s announcement he would lead a new healthcare venture formed Amazon, Berkshire Hathaway and JPMorgan.
“I’m delighted that that’s true that many things I’ve been talking about could get to matter,” Gawande, a professor at the Harvard T.H. Chan School of Public Health and Harvard Medical School, said during a general session presentation at the AHIP Institute and Expo in San Diego.
Aside from a view brief mentions bookending his presentation, Gawande largely stuck to his script, lamenting the amount of waste in healthcare and a systemic failure to adequately understand patient goals, particularly later in life when many are battling multiple chronic conditions.
He relayed a story about his mother, who underwent several invasive procedures after fainting, only to find out she was dehydrated after increasing the dosage of her heart medication.
“Over and over again, the care we provide is not in alignment with [paitents'] priorities,” he said. “The result of that is waste, care that does harm or provides no benefit, and enormous suffering.”
Though Gawande spoke in broad terms, his presentation offered a few subtle clues as to what he plans to focus on in his new position as CEO of the Amazon, Berkshire JPMorgan partnership. But he also left the stage without providing any concrete objectives or goals for the new project that remains largely undefined.
The need to refine system inefficiencies was a frequent theme. Gawande said providers “fail to deliver on the right thing, the right way, at the right time and are often doing things that of no value whatsoever.”
Rather than blaming physicians, however, he said the industry needs to make systemic changes to make it easy to provide the appropriate care and give providers the opportunity to transition from “technicians” to “counselors.”
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JPMorgan Chase CEO Jamie Dimon has previously laid out similar concerns around poor outcomes, high administrative costs and poor chronic disease management.
On the tech side of the equation, Gawande said the move to integrate patient-reported outcomes is “so fundamentally important.” Digital tools are making it easier to track those metrics, and even low-tech communication tools can connect clinicians to facilitate care coordination.
But just as Dimon and Berkshire Hathaway CEO Warren Buffet have warned their new venture is a long-term endeavor, Gawande said it could be a decade before the companies see a measurable impact.
“I’ll only say it is a long target and I'm lucky to have an expectation that we’re going to take on the kinds of problems I’m talking about over the next decade,” he said. “It’ll be gradual progress and there won’t be instant solutions.”