Conflicts of Interest Statement
I have multiple roles in health care and public health – as a surgeon, a public health researcher, journalist, and a health care delivery innovator. This diversity is by design; I believe that my effectiveness in each role benefits from the lessons and perspective that I gain from the others. My voice as a journalist, for example, is different from most other journalists; I am what some describe as an internal critic, who speaks from personal experience and observation inside the system.
The interplay of these roles also leads to legitimate concerns about conflicts of interest. For transparency, therefore, here is a list of organizations that I am part of or provide my income:
1) I am the CEO of a health care initiative founded by Amazon, Berkshire Hathaway, and JPMorgan Chase to incubate new models of health care delivery demonstrated to produce better outcomes, satisfaction, and cost-efficiency for employees and their families. This is an independent, not-for-profit organization, with all proceeds returning to support the mission of the initiative.
2) I am a surgeon and public health researcher for the Brigham and Women’s Hospital (BWH – member of Partners HealthCare), Dana Farber Cancer Institute, Harvard Medical School (HMS), and the Harvard T.H. Chan School of Public Health (HSPH). In my work for these organizations, I follow the HMS, HSPH, and Partners HealthCare conflict-of-interest policies.
3) I am the founding executive director and chair of Ariadne Labs, a health systems innovation center that is a joint venture of BWH and HSPH. Ariadne Labs, which works to discover scalable solutions proven to improve the delivery of health care, receives revenue from multiple philanthropies, foundations, and health care industry partnerships, which are listed on our website.
4) I serve as co-founder and chairman of the board of Lifebox, a nonprofit that makes surgery and anaesthesia safer on a global scale. I am a board member of the New America Foundation and co-chair of the Massachusetts Coalition for Serious Illness Care. I do not receive compensation for these roles.
5) My primary salary comes from the health care initiative I lead. I receive a part-time academic income, which is supported by my medical practice and my academic institutions. I also receive income as a staff writer for the New Yorker and author of books published by Metropolitan/Henry Holt in the United States and other publishers around the world. I also receive fees for occasional lecturing and public appearances from many different kinds of organizations.
I am clearly deeply embedded in health care and public health, in projects large and small. It is my life’s work and forms the basis for my writing and observations. In an effort to insure that medical companies do not pay to influence my research, writing, or leadership decisions, I take several steps: (1) No one, other than the publications where my work appears, pays me to write. (2) I don’t do paid consulting or advising for industry. (3) I don’t take fees for speaking to for-profit medical businesses, such as drug companies, device companies, or insurance companies. I do sometimes choose to speak before such audiences for the purposes of teaching and impact, but when I do I arrange for any fee to be donated to charity. (4) While the organizations that I am part of may partner with and receive funds from for-profit health systems, insurance companies, or other medical companies, I personally receive no income from such entities.
But I hope the most salient point about conflict is not missed, which is that I am an insider, a surgeon, researcher, and leader with deep commitments to the people who receive and deliver health care, as my readers will recognize. Some biases are unavoidable. I work hard to be as fair as I can in coming to my opinions and analyses. But I rely on you, the readers of my work, to be the final judge.
Updated September 4, 2018