Time to turn the page

Time to get back in the game.

Tomorrow morning will be my first day working at the Lance Armstrong Foundation, Livestrong. I’m excited for the structure, the mission and the opportunity of a full time job again. While I’ve been rearing to go for a few weeks now, the excitement of getting health insurance and a salary won’t quite compare to 11 months of adventuring:

• I quit my full-time job and moved out of Washington, D.C.
• I traveled the world for three months.
• I started freelancing in health IT market research.
• I traveled some more.
• I quit a startup I’d been involved with for two years.
• I drove 2100 miles through DC, Atlanta, and New Orleans to Austin.

But trying to compare the two is like comparing apples and fruit snacks. I’m happy to begin the next chapter tomorrow while I wrap up old projects and get a new one off the ground. You know Livestrong as the origin of those ubiquitous yellow bracelets. Well I quickly learned they’re about a whole lot more than that.  I’ll be overseeing a couple of projects the foundation has been embarking upon that bring health IT to some of the areas where it’s missing in cancer care, from patient tools and resources to the “big data” research agenda. I’ll be wading in policy issues and building a knowledge base in oncology and cancer care, essentially from scratch. I’m going to be working with a team of dedicated and inspiring colleagues, many of whom are cancer survivors themselves. Some of our board members are MD’s, but all are BFD’s. Also, I’m going to be working in a really sweet office.

So as one adventure comes to a close, another one begins tomorrow morning. Banzai!

“I was put on this earth to accomplish a certain number of things. Right now I’m so far behind I will never die.” – Bill Watterson

Two Hundred Years of Surgery

Dr. Atul Gawande at the office

Dr. Atul Gawande’s latest article is available for free on NEJM.

In his usual analytical-turned-conversational manner, he reviews the evolution of surgery over the last two hundred years. He describes the roles that milestone advances such as anesthesia, antiseptics and technology played in making surgeries more successful and more common. In a telltale sign that he is at heart a huge measurement-geek, he even consistently measures these advances against the number of articles in the NEJM devoted to them over the years. Squeamish beware: there are some juicy/graphic descriptions of operations performed. Here’s an excerpt about the public health horizon and the opportunity to discover more surgical innovation by transforming the delivery system (emphasis added):

The increased safety and ease of surgery have produced an explosion in the volume of operations being performed — to at least 50 million annually in the United States alone. At the present rate, the average American can expect to undergo seven operations during his or her lifetime. This profound evolution has brought new societal concerns, including how to ensure the quality and appropriateness of the procedures performed, how to make certain that patients have access to needed surgical care nationally and internationally, and how to manage the immense costs. As early as the 1970s, researchers began documenting substantial rates of fatal errors in surgical care, wide differences in outcomes among institutions, and large disparities in access to care both within the United States and between countries. The science of effectively routinizing surgery for mass populations is still in its infancy, as it is for all areas of medicine. The Journal is entering its third century of publication, yet we are still unsure how to measure surgical care and its results. Experiments in the delivery of care will probably provide the next major advancement in the field of surgery.

 Note – also check out his TEDMED talk in April, where he covers surgery from the professional angle, discussing individual improvement, the role that teamwork can play, and the phenomenon of cowboy-ing in surgery.

The Highlight of my Week

The man with the plan: Texas State Senator Kirk Watson, with Erin and I.

…was meeting State Senator Kirk Watson. He swung by our inaugural health2.0 kickoff event last night to show his support for our idea – to build a kickass health IT community in Austin.

Senator Watson has spearheaded the health reform movement here in Austin through taking on a list of initiatives. The movement and organization is called HealthyATX, and the goals include setting up a healthcare incubator in Austin, developing more innovative ways for health care delivery, and bringing a medical school to Austin. He’s already made some progress on the last one.

If I haven’t said it yet, this city is awesome.