Berwick Steps Down as Medicare & Medicaid (CMS) Administrator


This made news on Wednesday – Dr. Donald M. (Don) Berwick stepped down as CMS Administrator: “Harvard professor Don Berwick resigns as Medicare chief.”  I had supported Dr. Berwick… but it didn't really mean much because I'm not a U.S. Senator. Berwick, due to the recess appointment, was only able to stay in the role through the end of 2011 anyway, so the resignation probably isn't a big surprise to anybody.

For those of you who are attending the Institute for Healthcare Improvement (IHI) National Forum next week (the organization started by Berwick), it will be interesting to see if Berwick announces any future plans. Either way, I hope and expect that he will continue to be a leading voice in the healthcare quality and patient safety world. I won't be at IHI this year, but I hope one of you will send notes, particularly about Dr. Berwick's future.

In our upcoming book, Healthcare Kaizen, we cited Dr. Berwick and a New England Journal of Medicine article he wrote about kaizen and continuous improvement back  in 1989, citing the work of Masaaki Imai and so-called “Japanese manufacturing techniques,” as it would have been called in the day (we would now call it “lean”).

Not only is Dr. Berwick a great quality thinker and leader, he is extremely patient focused (so it's a shame he got smeared politically as being all about rationing and denying care). As cited in a recent Boston Globe blog post:  “Don Berwick on Medicare: Best job I've ever had,” with a great story:

Dr. Carolyn Clancy, director of the Agency for Healthcare Quality and Research, said Berwick has changed Medicare. Clancy talked about staff members setting up a meeting with Berwick to discuss an “arcane” dialysis rule, to find that Berwick had invited a dialysis patient in to discuss what the rule and what health care quality mean to her.

“You hear story after story like that,” she said.

As mentioned in the blog, Paul O'Neill (my podcast with him is here) was also a big supporter of Dr. Berwick. In an age of hyper-partisianship, there's a reasonable middle ground where a Republican (O'Neill) can support someone labeled as a liberal professor, or worse (Berwick).

Best wishes to Dr. Berwick in his future work…

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Mark Graban
Mark Graban is an internationally-recognized consultant, author, and professional speaker, and podcaster with experience in healthcare, manufacturing, and startups. Mark's new book is The Mistakes That Make Us: Cultivating a Culture of Learning and Innovation. He is also the author of Measures of Success: React Less, Lead Better, Improve More, the Shingo Award-winning books Lean Hospitals and Healthcare Kaizen, and the anthology Practicing Lean. Mark is also a Senior Advisor to the technology company KaiNexus.


  1. Unfortunate that Dr. Berwick got caught up in the partisan mess in Washington. Hopefully, he will continue to be a strong advocate for healthcare improvement.


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