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PALO ALTO, Calif. — It’s easy to think, from the headlines, that the future of health care is being forged on Capitol Hill. But the traditional centers of power and influence are losing ground — and talent — to the fertile, sometimes chaotic, environs of Silicon Valley.

What happens when top biomedical scientists and health policy experts head west? What do they find in California? And what lessons do they draw?


To find out, STAT invited five leading voices in California’s health care startup culture to a roundtable discussion at the offices of Mindstrong Health, a startup seeking to use data gathered from smartphones to diagnose and treat mental illness. A sixth interview, with Dr. Atul Butte, was conducted earlier in San Francisco.

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  • I lived in and received care at UCSF for 10 years and Kaiser for 2 years for chronic conditions which required surgeries, scans, infusions, multiple medication changes and frequent visits. I then moved back to Boston and am floored by how much I prefer my providers on the east coast (mostly at MGH). The communication skills and empathy are incredibly impressive across the board. I wouldn’t say my care at UCSF was lacking at the time, I definitely felt my Kaiser care was lacking in numerous ways (terrible!) but now I see what exceptional care from the front desk staff to the MDs can look and feel like.

    Say what you will about these higher-level issues healthcare, but as a patient, I vote east!

    Also, don’t forget that MA was the first state to have Obamacare!

  • In general, there has been an continuous migration from the Northeast to West and Southwest. This article explains very well how the landscape of healthcare is changing with Bay Area as future hub.

    Rajat Dhameja, MD, MHA

  • Dear Editor,

    This West Coast vs East Coast discussion does nothing, but give false impressions. We should be working together, collaborating, making it easier for Coast-to-Coast partnerships among scientists, investors, entrepreneurs.

    Of course there are issues/challenges/perceptions with the East Coast attitude: academic hierarchy, less open environment, not enough right talent, too focused on the science not enough on consumers, etc….some of these are true, and some are just anecdotal. Just like there are issues/challenges/perceptions with the West Coast attitude: working at FB or Amazon doesn’t prepare you to do genomics, internet & app skills are not necessarily transferable to the life sciences world, not everything is “digital health” or AI or “big data,”… some of these are true and some anecdotal.

    Hopefully we realize there are certain teams and individuals in both Coasts – and the rest of the country for that matter, that can greatly complement each others skills/assets/needs.

    But please for the love of God, let’s not say “healthcare innovation,” “AI ready,” “change the world,” if we can’t actually define it, achieve it and measure it.

    And one cannot put innovators in Boston in life science, with innovators in NY, or DC in the same bucket just because we are in the East Coast.

    Rodrigo M

  • I’m a Stage IV Rare Cancer patient (maybe 200 known US cases) . . . My father died of the gene mutation that causes my SDHB Deficient Gist (he had paragangliomas). I’ve been a patient at NIH under various protocols. I read the research papers and get frustrated by how many are analysis of patients (stats) instead of new ideas for treatment. I’ve also been frustrated seeing most the funding goes to East Coast labs while the researchers I email on the West Coast are willing to try new ideas and willing to respond to my emails. I mentor other patients trying to get them seen by anyone who’ll take a rare cancer patient. I know of ten patients with no treatment options and they are in their twenties, my own son’s age. I was hard losing a parent when you are a child to a cancer no one has ever heard of. Then to inherit it yourself and have found no new cures after 40 years. Surgery is our only bet and their are those who’ll say “no” to surgery because it isn’t curative. I live on the West Coast. I’m personally trying to get my tumor tissue to labs that have some new ideas. NIH won’t see me again because their “Gist” clinic is for “pediatric” and their SDHB protocol is for para/pheo tumors such as my father’s and aunt’s. They should be welcoming challenging cancer patients instead they say we’re too rare and slam the door.

  • Now, just imagine if we could harness the collective brain power and expertise of both coasts noted here towards common goals. Oops, I forgot those pesky non-disclosure agreements that limit collaboration. Yes, I know all the good (and specious) arguments for them but racing to be the first doesn’t mean racing to be the best.

  • the real reasons are

    more money, both salary wise and as more VCs willing to waste them in far off business (not necessarily good and meaningful) ideas

    and sunny warm weather

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