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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 Jul 1

    We take into account medical risks of patients but not, it seems, their social risks when we penalize clinicians for their results.https://nyti.ms/2tS86jf 

    12:44 PM - 1 Jul 2018
    • 377 Retweets
    • 702 Likes
    • Elmer Press Elizabeth Winer gmathews71 Anmol Gupta Solome Tibebu Snowball Promo Nicole Gudzowsky Sophy Tyler Ritu Thamman MD
    45 replies 377 retweets 702 likes
      1. Sherry Reynolds  🌟‏ @Cascadia Jul 1
        Replying to @Atul_Gawande

        We also fail to take into account someone's #sdoh when developing care plans, raising the price of drugs, coming up with a new app sending seniors home by themselves, or assuming they have healthy food to eat while healing from surgery FYI (20% of US kids live in poverty)

        0 replies 3 retweets 15 likes
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      2. Ken Mandl‏ @mandl Jul 1
        Replying to @Atul_Gawande

        On the other hand, I see risks in normalizing poor outcomes in disadvantaged patients.

        1 reply 1 retweet 7 likes
      3. Addi Faerber‏ @Addifaerber Jul 2
        Replying to @mandl @Atul_Gawande

        Or worse, blame bad health on #SDOH Determinants aren’t deterministic.

        1 reply 0 retweets 5 likes
      4. Chuck Webster MD MS AI 🤖 MS Industrial Engineering‏ @wareFLO Jul 7
        Replying to @Addifaerber @mandl @Atul_Gawande

        Ha! #sdoh Determinants aren’t deterministic!pic.twitter.com/iU2NkYFHQf

        0 replies 0 retweets 2 likes
      5. End of conversation
      1. Jane Liebschutz, MD MPH‏ @liebschutz Jul 8
        Replying to @Atul_Gawande

        Having moved from a safety-net hospital primary care practice x25 years to an academic hospital primary care practice with middle class patients, SDOH make it much more difficult to delivery high quality care for patients even with the same clinic resources!

        0 replies 2 retweets 7 likes
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      1. Gregg Fonarow MD‏ @gcfmd Jul 4
        Replying to @Atul_Gawande @boback

        And in the case of @CMSGov HRRP program heart failure patients paid the ultimate price of increased mortality. It is essential to get these programs modified to account for and adequately adjust for SE factors. @NMHheartdoc @coconnormd @ashishkjha @kejoynt

        0 replies 1 retweet 5 likes
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      1. Dmitry Oleynikov MD‏ @doleynik3 Jul 1
        Replying to @Atul_Gawande

        Very thoughtful look at an incredibly difficult problem. Solcial determinants of healthcare can often outweigh the medical issues. We must adress both or we are doomed to failure. I for one will not offer elective surgery when I know the pt has no chance for success. No choice ER

        0 replies 1 retweet 4 likes
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      1. James Marroquin‏ @Jamesmarroquin Jul 1
        Replying to @Atul_Gawande

        So glad this is beginning to be recognized by policymakers. Current value-based payment methods minimally take social determinants of health into account. This incentivizes caring for pts most able to adhere to docs’ recommendations rather than pts w/ socioeconomic challenges

        0 replies 1 retweet 3 likes
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      1. Andrey Ostrovsky, MD‏Verified account @AndreyOstrovsky Jul 2
        Replying to @Atul_Gawande @MarieZMedicaid

        Fortunately @cityblockhealth here to address this issue!

        0 replies 0 retweets 4 likes
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      1. Dr. Keri Althoff‏ @kerinalthoff Jul 2
        Replying to @Atul_Gawande

        Social determinants of health (#sdoh) are often harder to measure and more complex to understand, but must be considered due to their large and relentless impact on health outcomes.

        0 replies 1 retweet 1 like
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      1. LaToya V. Wells‏ @LaToyaVWells Jul 1
        Replying to @Atul_Gawande

        Congrats on your new role @Atul_Gawande. Glad to see that quality of care provided to patients, especially the most vulnerable, is being introduced into the conversation and reimbursement. Looking forward to the innovative ideas from the new venture.

        0 replies 0 retweets 4 likes
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      1. J. Bradford DeLucy‏ @01wise Jul 1
        Replying to @Atul_Gawande @SableViews

        What if we addressed the socioeconomic barriers that poor people face rather than trying to tweak the P4P playing field?

        0 replies 0 retweets 3 likes
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      2. Sherry Reynolds  🌟‏ @Cascadia Jul 1
        Replying to @Atul_Gawande

        Btw I don't know many Docs who are being "hurt financially" by caring for the poor - Ave US doctor makes ~ $300k: year (cardiologist $423) but I do know many patients who go can't afford care. Medscape Physician Compensation Report 2018 https://www.medscape.com/slideshow/2018-compensation-overview-6009667?src=soc_tw_share … via @medscape

        1 reply 1 retweet 2 likes
      3. 1 more reply
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      2. Deepti‏ @MdDeepti Jul 1
        Replying to @Atul_Gawande

        It’s about time EMR’s catch up and capture smart data around social determinants of health

        1 reply 0 retweets 3 likes
      3. 1 more reply
      1. Rajaie Batniji‏ @RBatniji Jul 2
        Replying to @Atul_Gawande

        I couldn't agree more, @Atul_Gawande. We should be measuring social risk in assessing outcomes. And, payers can use social risk information to augment coverage and provide support that targets individual and group social risks. We @Collective make this central in our care models.

        0 replies 0 retweets 2 likes
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      1. Gale Pryor‏ @G_Pryor Jul 1
        Replying to @Atul_Gawande

        One low cost, high impact solution to addressing social determinants of health: community health workers

        0 replies 0 retweets 2 likes
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      1. Matthew Wynia‏ @MatthewWynia Jul 1
        Replying to @Atul_Gawande

        Complex topic; we should pay more for care that takes more resources, but we should not allow lax quality standards for those serving disadvantaged groups, entrenching disparities.

        0 replies 0 retweets 2 likes
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      2. Sundar Sivaraman‏ @tweetsundr Jul 1
        Replying to @Atul_Gawande

        Is there a parallel with how teachers are measured by students progress in public schools? Socio economic factors as well as an unstable home environment seems to have a negative impact on studies. Some common threads perhaps?

        1 reply 0 retweets 2 likes
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