Don Berwick: Health Care as a Loving Relationship

For the past 30 years, Donald Berwick has been one of the nation's leading authorities and innovators of quality and improvement in the U.S. healthcare system. A pediatrician by training, a professor at both Harvard Medical School and the School of Public Health, and a top health care administrator during the Obama Administration, Berwick challenges administrators, policy makers, and doctors to go beyond the standard discussion of systems, strategies, and statistics to something more essential, more human--something he considers moral. The secret to improving quality in medical care, he argues, is love.

“Healthcare is more about love than about most other things,” Berwick says. “It’s not just the quality of mercy, it’s the mercy of quality.” He believes no one should be left behind.

Berwick was deeply influenced by his Jewish upbringing, which taught him about the importance of being a steward of society and the world at large. In addition to Judaism, he has been greatly influenced by the Dalai Lama. Both Judaism and Buddhism remind him we’re all in this together and therefore have to help each other. “If there isn’t at the core two human beings who have agreed to be in a relationship,” he says, “where one is trying to help relieve the suffering of another, which is love, we can’t get to the right answer.”

His article, "Choices for the 'New Normal'" published in the early months of the pandemic outlines "6 properties of care for durable change: tempo, standards, working conditions, proximity, preparedness, and equity."

In addition to teaching, he serves as President Emeritus and Senior Fellow of the Institute for Healthcare Improvement and was the former Obama-appointed Administrator of the Centers for Medicare & Medicaid Services. He is also on staff at Boston's Children's Hospital, Massachusetts General Hospital, and the Brigham and Women's Hospital. Among his numerous awards and honors, he was knighted by Queen Elizabeth II in 2005, in recognition of his work with the British National Health Service. Dr. Berwick is the author or co-author of over 200 scientific articles and six books.

Berwick is further impassioned by his grandchildren. He wants to hand them “a planet that is really thriving.” So he looks at the greater contexts outside traditional definitions of healthcare that nurture or impair our collective health—social factors such as racism, for example. He calls for an attack on these social determinants of disease, combined with an embrace of the moral determinants of health, which requires solidarity.