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'You Really Listen'
Profile on Don Berwick

U.S. World & News Report July 18, 2005
By Cory Hatch from the Best Hospitals - Special Report

Every winter, when Donald Berwick isn't busy reforming healthcare in his Cambridge, Mass., office, he's perfecting his cross-country skiing technique out in New Hampshire's backwoods. Tweaking the angle of his kick or his grip on the ski poles nibbles away a few seconds here and there. "Tiny changes can make the difference between whether you're grunting and sweating or flying up the hill," he says.

Berwick sees the world as something that could and should be perfected--including healthcare. The Institute for Healthcare Improvement, which he cofounded in 1991, spends much of its time identifying small, simple modifications that pay off in lower costs and fewer deaths and injuries.

Berwick, now age 58, gained a reputation at Harvard Medical School in the 1960s for helping low-income neighborhood residents find healthcare. Later, as a pediatrician, he nearly crawled inside his young patients to figure out what was wrong with them. "When you're doing medicine properly, you sit down, you focus on the patient in front of you, and you really, really listen," says Berwick, quoting a former teacher.

In the mid-1980s, Berwick and fellow pediatrician Paul Batalden gathered a group of friends, sometimes on Batalden's birthday, to talk about improving healthcare. The seeds of IHI were sown at the "birthday club" meetings. Most attendees became board members.

Single-minded. Discussing healthcare reform at birthday celebrations is in character for Berwick and his band, who speak with the zeal of radicals. Even on vacation, say friends, conversations invariably return to healthcare.

Berwick's curiosity and open mind are renowned, whether he is picking the brains of Toyota engineers for tips on workflow or coteaching a "Quality of Healthcare in America" course to Harvard undergrads. "I had some minor quibble with an argument he made but wasn't going to come out and say so," says former student David Gellis. "He was able to see where I was going and encouraged me to ask my question. I was blown away by that."

Soft-spoken and approachable, Berwick is also known for funny and moving anecdotes in his speeches and presentations and for humanizing his theories. He is also very frustrated with the slow pace of healthcare reform. His father, his wife, and Berwick himself have each experienced medical fiascoes, and each has starred in his talks.

Take Berwick's sore right knee. After a soccer injury in medical school, a doctor performed a now-discredited procedure on Berwick that eventually left him with osteoarthritis. The bones of his knee rub together, most likely because of the surgery. Last January, Berwick half-humorously issued a public "request for bids" to the healthcare system at large to fix his knee. First on his list of six simple requests: "Don't kill me."

Berwick wants high-quality care for everyone, and he wants it now. A friend once said in a speech that trying to make quick changes to swollen public institutions such as healthcare is like incubating a chicken egg with a blowtorch: You get a burned mess, not a baby chick. But Berwick won't back off. "I keep seeing the toll," he says. "I'm close enough to watch people get hurt. We need to turn the blowtorch on when it will help."
Copyright U.S. News & World Report 2005