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Atul_Gawande's profile
Atul Gawande
Atul Gawande
Atul Gawande
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@Atul_Gawande

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Atul GawandeVerified account

@Atul_Gawande

Surgeon, Writer, Researcher, Dilettante. https://www.ariadnelabs.org/  http://www.lifebox.org/ 

atulgawande.com
Joined January 2011

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    Atul Gawande‏Verified account @Atul_Gawande Jun 23

    Atul Gawande Retweeted Amitabh Chandra

    Very good question...https://twitter.com/amitabhchandra2/status/1010588856184442886 …

    Atul Gawande added,

    Amitabh Chandra @amitabhchandra2
    Why have Kaiser that insures 10m lives and United that insures 45m lives failed at this, and how will Atul make more progress with 1m lives? #HealthPolicyTwitter will view this as being stubborn, but it's a question that MBAs are trained to ask https://twitter.com/sangerkatz/status/1010544864059056133 …
    7:57 PM - 23 Jun 2018
    • 74 Retweets
    • 426 Likes
    • Judith Lindsay Ricky Bloomfield Vatsal G. Thakkar MD Pauline Dawson Siva Kaliamurthy MD Canidae Nisarg Patel Ben B. rc reed
    52 replies 74 retweets 426 likes
      1. New conversation
      2. Billy Jalbert‏ @Mauibilly Jun 23
        Replying to @Atul_Gawande

        Where does proactive health / wellness fit into the picture?

        1 reply 0 retweets 1 like
      3. Umbereen Nehal‏ @usnehal Jun 23
        Replying to @Mauibilly @Atul_Gawande

        I would say under social determinants. Fitness and wellness are often a matter of access to resources for that

        1 reply 0 retweets 3 likes
      4. Umbereen Nehal‏ @usnehal Jun 23
        Replying to @usnehal @Mauibilly @Atul_Gawande

        Example: when I was in pediatric residency in Houston, where obesity is rampant and asthma is prevalent and severe, children could not simply play or bike outside given the built environment, roads, pollution, heat. Those with access/resources for gyms, ok. But that is not most.

        2 replies 1 retweet 9 likes
      5. Umbereen Nehal‏ @usnehal Jun 23
        Replying to @usnehal @Mauibilly @Atul_Gawande

        Another example: visiting Hartford for a conference with my sister’s family, I offered to get fresh fruit for sister’s kids. Drove blocks and only found bodegas with cerveza, canned foods, lotto tickets maybe a banana. Imagine trying to eat healthy in that “food desert.”

        1 reply 0 retweets 7 likes
      6. Umbereen Nehal‏ @usnehal Jun 23
        Replying to @usnehal @Mauibilly @Atul_Gawande

        I only recently learned the term “food swamp” as what is more correlated with obesity: https://www.theatlantic.com/health/archive/2017/12/food-swamps/549275/ … “In addition to being low on grocery stores, food swamps are also crammed with unhealthy food options like corner stores and fast-food places.”

        1 reply 0 retweets 5 likes
      7. Umbereen Nehal‏ @usnehal Jun 23
        Replying to @usnehal @Mauibilly @Atul_Gawande

        “researchers from the University of Connecticut’s Rudd Center for Food Policy and Obesity compared the obesity rate of U.S. counties to their ratio of fast-food restaurants and convenience stores to grocery stores and supermarkets—their level of food-swampiness, in other words.”

        1 reply 0 retweets 4 likes
      8. Umbereen Nehal‏ @usnehal Jun 23
        Replying to @usnehal @Mauibilly @Atul_Gawande

        “The food swamps had about four unhealthy options for each healthy one. ..The relationship between food swamps and obesity was especially strong in areas where people lacked both their own cars and access to public transportation.”

        1 reply 0 retweets 3 likes
      9. Umbereen Nehal‏ @usnehal Jun 23
        Replying to @usnehal @Mauibilly @Atul_Gawande

        I believe that about the link to a car or public transportation. Even with a car and GPS to identify what looked like grocery stores, I was stymied. Drove and drove and drove. That transportation issue applies the access through care too, hence this: https://www.bcbs.com/news/press-releases/blue-cross-and-blue-shield-and-lyft-join-forces-increase-access-health-care …

        1 reply 0 retweets 6 likes
      10. 3 more replies
      1. Gerard Doherty‏ @gmdoherty Jun 23
        Replying to @Atul_Gawande

        If it were obvious & easy, it wouldn’t be worth taking on. Would be done already. But - there might be entrenched elements that require sunlight to reveal motivations around status quo. 😉 Of course there are. We couldn’t have a better experimenter to investigate. I’m in.

        0 replies 0 retweets 12 likes
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      1. John Chamberlain‏ @misterchambo Jun 24
        Replying to @Atul_Gawande

        Here’s one answer: 1) Restore the physician/patient relationship aka disintermediation or Direct Patient Care 2) Reinstate reasonably priced catastrophic only policies 3) Mandate price transparency via independent, 3rd party (non-insurance-based) platforms 4) Expand HSA avail

        0 replies 1 retweet 3 likes
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      1. Tom Solberg‏ @SolbergTom Jun 23
        Replying to @Atul_Gawande

        Have faith that smart people who put their heads together without being burdened by legacy systems and “old” thinking can innovate their way out of this mess. Best of luck, Dr. Gawande and team.

        0 replies 0 retweets 4 likes
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      1. Chris M. Shoffner‏ @CShoffTCB Jun 24
        Replying to @Atul_Gawande

        This is not a hard problem to solve, just one in which entrenched special interest have milked the system via Medicare/Medicaid and private policies. #universalprimarycare is the starting point. Then buy portable insurance for your risks...

        0 replies 0 retweets 2 likes
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      1. DavisLiuMD‏ @davisliumd Jun 23
        Replying to @Atul_Gawande

        No comparison - comparing @KPShare with @UHC is like comparing @Apple with @Android / @Microsoft. Apples and oranges (pun intended) - both are fruit but fundamentally different. http://www.davisliumd.com/wp-content/uploads/2016/05/LIU-Final-Board-Presentation-5-2014-1.ppt …

        0 replies 0 retweets 2 likes
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      1. jeet 🐊‏ @jeetsidhu_ Jun 23
        Replying to @Atul_Gawande

        Healthcare as a % of GDP grew from ~6% in 1965 to ~18% today (!). Life spans increased ~5 years during that time driven by lifestyle changes - not paying more or getting more care. Give them hell!

        0 replies 0 retweets 2 likes
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      1. New conversation
      2. Rohit Mehta‏ @rohitdukemehta Jun 25
        Replying to @Atul_Gawande @EJSMD

        Starts with Buckeyes questioning the status quo- @Atul_Gawande- Erin allen and I have faith in you! Deconstruct what exists, reestablish core principles- let innovation work around these- start with #patientfirst as the core! How can I help? @EJSMD you ready? #allinforpatients

        1 reply 0 retweets 2 likes
      3. 1 more reply
      1. John Hoben‏ @jhoben Jun 24
        Replying to @Atul_Gawande

        What’s your “one thing” upon which to focus, like Curly asked Billy Crystal’s character in “City Slickers,” Dr. Gawande? @CitizenHealthio

        0 replies 0 retweets 1 like
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      1. george valko‏ @george_valko Jun 24
        Replying to @Atul_Gawande

        And we hope you have the answers! Looking forward to the next few years!

        0 replies 0 retweets 1 like
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      1. Wayne Saltsman‏ @WayneSaltsman Jun 24
        Replying to @Atul_Gawande

        Who’s up for ‘just culture’, appreciating the impact of social determinants of health, advance care planning, and doing the ‘right thing’ through education and communication? If that’s the plan, then I’m ‘all in’!

        0 replies 0 retweets 1 like
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      1. Suchi Saria‏ @suchisaria Jun 24
        Replying to @Atul_Gawande

        Perhaps this is an opportunity to use public/private partnerships to advance the right types of policies.

        0 replies 0 retweets 1 like
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