the new gatekeepers

From medical writer to health-care CEO: the Atul Gawande story

June 20, 2018

One day you’re a staff writer at The New Yorker and the next day you’re the CEO of a health-care startup backed by Warren Buffett, Jeff Bezos, and JP Morgan Chase. A fever dream? Not if you’re Atul Gawande, whose appointment was announced on Wednesday. Of course, Gawande is no ordinary writer. He is also a surgeon who practices at Brigham and Women’s Hospital in Boston, a professor of surgery at Harvard Medical School, and a professor at Harvard’s T.H. Chan School of Public Health, as well as the author of four books about medicine. His TED talk on how to fix modern medicine has 1.8 million views, and he won a McArthur “Genius” grant in 2006.

Gawande also has an interesting history with Buffett’s investment firm Berkshire Hathaway, one of the backers of the new medical startup (which doesn’t have a name yet). After he wrote an article for the New Yorker in 2009 about a Texas town with one of the highest rates of medical spending in the country—a piece that was cited by then-president Barack Obama during his fight to restructure Medicare—Gawande received a check for $20,000 from Buffett’s longtime business partner, Charlie Munger, in thanks for his perceptive writing (Gawande donated the money to Boston’s Brigham and Women’s Hospital).

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The exact nature of the startup that Gawande will be running is largely unknown. The announcement was made in January by Berkshire Hathaway, Amazon, and JP Morgan Chase, and it appears that the three firms have agreed to pool their resources to find a better way to offer health care to their employees, who number more than one million. The joint venture will focus on technology that enables them to provide care “without profit-making incentives and constraints,” according to a recent New York Times article, which added:

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It was unclear how extensively the three partners would overhaul their employees’ existing health coverage — whether they would simply help workers find a local doctor, steer employees to online medical advice or use their muscle to negotiate lower prices for drugs and procedures. While the alliance will apply only to their employees, these corporations are so closely watched that whatever successes they have could become models for other businesses.

So what might this new entity look like? Erik Gordon, a professor at the University of Michigan’s Ross School of Business, told the Times he expects the companies will try to modernize the health-care process by “making it look more like booking a restaurant reservation on OpenTable.” Others said Amazon might create a kind of virtual health-care assistant that could act as a concierge to help people through the process. Some think the three giants may use their combined muscle to try to cut the cost of medication.

Gawande has said he will continue to work as a professor, surgeon and writer while also being CEO of the new startup (the New Yorker confirmed to CJR that he will continue to write for the magazine). But will be able to tackle this monumental challenge while continuing to wear all those other hats? Some are skeptical (and others are skeptical of the new venture for other reasons), but anyone who has followed Gawande’s career knows better than to count him out before the fight begins.

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Mathew Ingram is CJR’s chief digital writer. Previously, he was a senior writer with Fortune magazine. He has written about the intersection between media and technology since the earliest days of the commercial internet. His writing has been published in the Washington Post and the Financial Times as well as by Reuters and Bloomberg.