Atul Gawande

Atul Gawande was selected to lead Haven, the highly publicised joint venture between Amazon, Berkshire Hathaway and JPMorgan intended to transform healthcare costs and quality for their employees. STAT documented difficulties defining a strategy, significant staff turnover and overlap with internal initiatives of the founding companies. Gawande stepped down as CEO in 2020, and Haven announced its closure in early 2021.

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During his nomination as USAID Assistant Administrator for Global Health, Senator Marco Rubio temporarily blocked progress on the nomination, citing a 1998 essay by Gawande on abortion and moral dilemmas surrounding birth. Rubio characterised certain passages as a defence of infanticide, which reproductive rights organisations disputed, describing the text as more complex.

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Gawande was one of the principal authors and promoters of the WHO surgical safety checklist, associated in early studies with substantial reductions in mortality and complications. In 2014, a study of more than 200 000 procedures in 101 Ontario hospitals found no statistically significant reduction in mortality or complications following mandatory introduction of the checklist, prompting debate about the robustness and generalisability of the initial findings.

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In his influential article 'The Cost Conundrum', Atul Gawande described McAllen, Texas, as an example of medical overuse and indicated that commercial insurance data pointed in the same direction as Medicare. A subsequent Blue Cross study showed, by contrast, that average spending on privately insured patients in McAllen was slightly lower than in El Paso, challenging the idea that McAllen doctors indiscriminately overtreated all patients.

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In 2009, single-payer healthcare advocates publicly questioned Gawande's ties to the insurance industry following an appearance before an industry organisation, asking why New Yorker readers were not better informed of these relationships. The episode prompted Gawande and the magazine to clarify the arrangements for his paid speaking engagements.

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Directly implicated