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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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    1. Amitabh Chandra‏ @amitabhchandra2 Jan 30

      "Performance-based pay...is irrelevant to the complexities and professionalism of good doctoring and other human services like education." https://www.statnews.com/2018/01/30/pay-for-performance-doctors-hospitals/ … via @statnews

      10 replies 108 retweets 153 likes
      Atul Gawande‏Verified account @Atul_Gawande Jan 30
      Replying to @amitabhchandra2 @statnews

      So what next? I think the key is learning to systematize better care -- investing in the hard work of discovering how to make good, efficient care easier for groups of clinicians.

      4:45 AM - 30 Jan 2018
      • 8 Retweets
      • 19 Likes
      • Leander Deb Soc Carol Shannon Dr. Marcia Whalen Dennis Deruelle, MD Douglas Grey Diane Penna Gorski C. Tutein Nolthenius Joe Colucci
      1 reply 8 retweets 19 likes
        1. New conversation
        2. Atul Gawande‏Verified account @Atul_Gawande Jan 30
          Replying to @Atul_Gawande @amitabhchandra2 @statnews

          How? Well, we have to at least not penalize that kind of work/innovation. Which still means learning ways to move away from fee for service which does that opposite. This is a matter of iteration, not simply testing and rejecting, pay for value approaches (like capitation, ACOs).

          5 replies 3 retweets 11 likes
        3. Atul Gawande‏Verified account @Atul_Gawande Jan 30
          Replying to @Atul_Gawande @amitabhchandra2 @statnews

          Analogy: For a decade, the effort to bring genomics to the bedside failed to produce much evidence of value. But we supported innovation and are now in the flowering of remarkable breakthroughs. We likewise need to support lots of innovation in payment methods and delivery.

          2 replies 8 retweets 17 likes
        4. Amitabh Chandra‏ @amitabhchandra2 Jan 30
          Replying to @Atul_Gawande @statnews

          Key is 2 things you said: groups of clinicians and iteration. Both point to focusing on well-defined medical conditions first, and then expanding towards capitation. Much harder to iterate on an ACO than on a bundle. Physician-led ACOs/Medical Homes picking bundles is promising.

          1 reply 2 retweets 10 likes
        5. Amitabh Chandra‏ @amitabhchandra2 Jan 30
          Replying to @amitabhchandra2 @Atul_Gawande @statnews

          Hospital-led ACOs are too complicated an entity and about as useful as Pharma-led ACOs. Doctors within them are inadequately empowered to deliver the improvement we want; the larger the team, the more the free-riding and lack of responsibility.

          1 reply 1 retweet 8 likes
        6. Daniel Ludwinski‏ @dcludwinski Jan 30
          Replying to @amitabhchandra2 @Atul_Gawande @statnews

          Is the hospital led vs physician led difference that firmly established? Can you point me to the best research?

          1 reply 0 retweets 0 likes
        7. Amitabh Chandra‏ @amitabhchandra2 Jan 30
          Replying to @dcludwinski @Atul_Gawande @statnews

          I was sharing my intuition on physician-led ACOs— @Farzad_MD is the man on this

          1 reply 0 retweets 1 like
        8. Daniel Ludwinski‏ @dcludwinski Jan 30
          Replying to @amitabhchandra2 @Atul_Gawande and

          Great. Thanks-was afraid I had missed something and would need to reevaluate some of my research

          1 reply 0 retweets 0 likes
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