Exclusive Interview: Dr. Sachin Jain Leaves Merck to Join CareMore

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Visit the NEJM Group Open Forum starting Thursday morning, January 15, to ask Dr. Jain questions about his new role at CareMore.

Dr. Sachin Jain announced this week his decision to leave Boston-based pharmaceutical company Merck & Co. to become Chief Medical Officer at CareMore, an Anthem subsidiary and Los Angeles-based integrated care plan that combines a Medicare Advantage plan with 24 care centers across the country. Jain was the Chief Medical Information & Innovation Officer at Merck.

Dr. Jain is something of a wunderkind in the medical field. He has an MD and MBA from Harvard and has already worked heavily in the area of health data improvement. While working at Merck, Dr. Jain served as an attending hospitalist physician at the Boston VA – Boston Medical Center. He was also a lecturer in healthcare policy at Harvard Medical School. Before joining Merck, Jain was a senior advisor to the administrator of the Centers for Medicare and Medicaid Services, where he helped launch the Center for Medicare and Medicaid Innovation. He also worked in the Office of the National Coordinator for Health Information.

Dr. Jain’s big career move has many physicians asking big questions: Can innovation truly happen in the pharmaceutical sector? Do CMIOs find their roles to be effective, or is the newly implemented position mired in frustration? And most poignantly, why did Dr. Jain make this big career switch? We sat down with him to answer all of your questions.

Q: Let’s start at the beginning. Can you take us back to your decision to join Merck? Why join a pharma company as a physician? 

For me, joining Merck felt like an opportunity to build something new at an important and impactful company. They have an incredible reach in over 135 countries and their products have helped so many patients, so our innovations had the ability to have a global impact. There are few opportunities like that. They created my role for me, which was also appealing. So I built a team and strategy from scratch.

One key part of my decision was also the opportunity to work with Michael Rosenblatt, whom I deeply admire. He has had an extraordinary career and he’s a nice person. He became my mentor. Working with him and learning from him was too good to pass up. Often people ask me about advice when they’re writing features, and I’d say that one of the things I’ve done is follow people who I think are extraordinary. I was lucky to be connected with Mike.

Q: What were you hoping to achieve while you were at Merck?

I had three domains of what I wanted to do. First, I wanted to build access to real world data. One of the really interesting things about pharma is that we develop drugs but we often don’t have data on what’s happening to patients in the real world. So we built a strategy to build relationships with delivery systems and payers. My second goal was clinician facing – developing EHRs that help patients take the right meds at the right times. And third, I wanted to develop patient-facing technologies to enhance patient engagement.

Q: It sounds like you were pretty happy at Merck – which begs the big question: Why are you leaving?

One of the things that’s most important to me in healthcare innovation is hands-on care delivery. At Merck, we operated through partnerships. I was exposed to CareMore originally when I was working for the government. We looked for examples of organizations who were pushing forward at the frontier of what was possible for frail populations, and I kept hearing about CareMore.

If you think about the roots of clinical medicine, being doctors, what we’re supposed to accomplish and what we need to do to transform care, CareMore offers exciting and highly impactful opportunities. So when I was given the opportunity to go and lead the clinical organization there (I’ll be the CMO) and to scale their work in other geographies, it was a dream.

Obviously, it’s hard to say goodbye to Merck and my mentors. And it’s very hard for me to say goodbye to Boston – I’ve been here for 16 years. But I’m moving to LA because I deeply believe in CareMore. They have innovation in their bones, with clinicians and nurses pushing the frontiers of what’s possible for the population.

Q: From what you’ve said, it sounds like your switch is largely an effort to be more “on the ground.” I’ve heard that you even continued to work as a physician, unpaid, at the VA while you were at Merck. Why is on the ground work so important for innovation?

My primary identity has always been as a physician. You cannot be an authentic leader in healthcare unless you have a depth of clinical contact and you maintain that depth.

Here’s a story: At one point in my career, I was about a year removed from seeing patients and it became clear that my perspective had shifted. When you talk about changing the practice of healthcare, there’s what you do in a board room and what you do in a clinical practice while you’re watching care happen. When you see care happen, you start to understand the nuance of how to change healthcare delivery. When someone asks whether to continue in clinical practice, I say it’s not optional. You need it. If you move away, you end up short-selling your potential impact in healthcare. Your perspectives won’t be as informed as they could be.

Q: We’ve seen several CMIOs transition into new roles this month – both you and Dr. Naomi Fried of Boston Children’s. What is it about the CMIO role? Is it too difficult to innovate inside a big organization?

I think this is a reflection of broader convergence happening in healthcare, not a failure. Larger organizations are complex, but they present special opportunities to scale impact. I have the opportunity to dream really big – Anthem, CareMore’s parent company, impacts more than 37 million Americans. There are certainly many ways to innovate and this is just one way. It’s not easy. I’ve worked with the federal government and that’s not easy – it’s complex. But I always think “If I can move this battle ship one tiny bit this way or that way, I can see a huge impact.” The scale is amazing and worthwhile.

Q: This is a bit of a non-sequitur, but let’s wrap this up by talking about the healthcare system as a whole. Physicians have called out different improvement areas for 2015 – EHRs, wearables, interoperability. Where do you see potential for improvement?

I’ve always said that we shouldn’t lose the care in healthcare. Preserving the good will and intent of nurses and physicians so they can deliver good care to patients is important, and I think we often forget the folks who actually take care of patients on the ground. We need to make sure medicine and nursing are still rewarding. Healthcare should be high touch and low cost – and I don’t mean touch as in an email. I mean hands on. CareMore is very high touch. They’re an organization that uses technology to know their patients even better.

I think getting incentives right also matters. We need clear alignment between clinicians, patients and hospitals to make sure people are rewarded for doing the right thing – right now things are confusing regarding systems vs. patients.

And finally, we need to start having a more authentic national dialogue about healthcare. If you go to conferences, you’ll hear people say “We’ve got X billion in waste.” But we can’t forget that the waste is someone’s profit, someone’s job and someone’s revenue. The question is how do we transition this industry so we’re rewarding organizations for doing the right thing for patients. Often times, doing the right thing is actually against a physician’s financial well-being. This can only be sustainable for so long.

Do you have questions for Dr. Jain? Lucky for you, he’s this week’s NEJM Group Fascinating Physician. Visit the NEJM Group Open Forum starting Thursday, January 15.

Jenni Whalen

Jenni Whalen

    Jenni Whalen is the Executive Assistant of Editorial at Upworthy. She was previously MedTech Boston's Managing Editor and has an MS in Journalism from Boston University, as well as a BA in Psychology from Bucknell University. Whalen has written for Greatist, Boston magazine, AZ Central Healthy Living and the New England Journal of Medicine, among other places. She has also worked as a conference planner, ghost writer, researcher and content developer.

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