TED Talks Daily: "A different way to measure success in health care"

Guest: Andrew Bastawrous
Host: Lily James Olds (TED Fellows Director), with TED Team
Airdate: February 6, 2026

Overview

This episode explores a provocative shift in healthcare measurement, led by Andrew Bastawrous, eye surgeon and CEO of Peak Vision. Instead of prioritizing speed and efficiency, Bastawrous argues for measuring compassionate, deep, and human-centered care—suggesting this approach yields better outcomes for both patients and healthcare workers. The episode blends Bastawrous’s personal stories, insights on scaling health tech globally, and a thoughtful conversation on the need to redesign both our health systems and mindsets for greater presence and connection.

Key Discussion Points & Insights

1. The Dilemma: Efficiency vs. Compassionate Care

• Traditional Healthcare Models: Overwhelming pressure for speed and volume means practitioners see patients repeatedly and superficially.
  • “Currently, the pressure on the healthcare system means we'll choose to see someone three or four times superficially rather than once or twice deeply.” (Andrew Bastawrous, 03:34)
• Bastawrous’s Alternative Proposal: Deep, meaningful engagement with patients, even if less frequent, leads to better outcomes for all.
  • “I'd like us to show the evidence that once or twice deeply actually leads to better outcomes for both the patients and the health workforce.” (03:45)

2. The Power of Presence: A Personal Anecdote

• Story of Jackie (Patient):
  • Bastawrous recounts a patient encounter that shifted his perspective. Jackie, who delayed cataract treatment to care for her dying daughter, found more value in being listened to than in the clinical result itself.
  • “The greatest gift I could give her was not her sight, but to have her be truly seen.” (05:32)
• Insight: Active listening and genuine presence changed the patient’s healthcare experience profoundly—a theme Bastawrous urges should be systematically measured.

3. Scaling Compassion: The Evolution of Peak Vision

• Technology for Scale:

  • Peak started in Kenya with mobile eye clinics. Realizing the impracticality of scale, they shifted to a smartphone-based system for screening and referrals, now reaching a million people every two months.
    • “In 2014, we'd seen 7,000 people over two years, but today we reach a million people every two months.” (06:58)
  • Unintended Consequence: Technology that optimizes efficiency may compromise human connection—the very reason Peak was founded.
    • “There was all of these metrics that allowed people to know how many seconds it took them... and it was tracking everything around efficiency, performance. And we've decided...we started this not as a means of efficiency, but as a means of compassion.” (07:26)

• Redesigning Metrics:

  • New trials in India: half the screeners are given extra time and measured on how many patient stories they remember rather than throughput.
    • “Their key performance indicators are going from how many people they've screened and referred to how many stories they remember...” (07:54)
  • Preliminary Results: Fewer patients per day seen, but significantly more show up for treatment overall, with higher satisfaction and less staff burnout.

4. Barriers & Levers in Global Eye Care

• From Diagnosis to Treatment:
  • The biggest global barrier is not diagnosis but patient “completion of journey”—people often aren’t aware that treatment is possible or don’t know how to access it.
  • Peak’s solution: intuitive tech for non-specialists, automated parent/caregiver notifications, behavioral “nudges” for headteachers to support child follow-through.
    • “We built in an automated messaging service... but content, frequency and the recipient (like headteachers) made an even bigger difference.” (13:29–15:44)

5. AI: Double-Edged Sword

• Potential and Peril:
  • AI can amplify both good and bad trends. Current drivers risk increasing inequality, with tech and productivity gains benefiting the already-served, while a billion people still lack basic glasses.
    • “I don't see people talking about how are we going to use AI to close that gap.” (18:06)
  • Design Principle Needed: AI should prioritize inclusion and service to the neglected, not only efficiency and novelty.

6. Slowing Down to Speed Up: Personal and Workplace Practices

• Practices Bastawrous Follows:
  • Calendars: Starting his workday later to allow unscripted neighborly connections and presence with family.
    • Story: “I just moved my day to start at 9:15...in those unscripted moments, some really beautiful conversations have happened.” (21:59)
  • Headphones: Sharing the Joshua Bell experiment as a parable about the costs of constant rushing and inattention; most passersby failed to notice musical genius in plain sight.
    • “It's a story about us. It's about what speed does to our souls and how we're constantly, constantly rushing and we miss...obvious, beautiful moments.” (25:31)

7. Designing for Care: Hard Evidence and Organizational Recommendations

• Early Results from India Pilot:
  • When care environments emphasize story and empathy over throughput, more patients participate, fewer staff burn out, and trust in health systems increases.
    • “The outcome that matters to us is that that person turns up and gets treatment that works, as opposed to how many people were tested.” (29:53–31:23)
• Advice for Leaders:
  • Remove distractions, model undivided attention (e.g., phone away during conversations), and design for clarity not certainty.
    • “You have to work hard at creating the space to not be busy. I think a lot of that comes from...clarity. Clarity comes from doing the deep work...” (33:37–34:59)
  • Small structural changes—no-meeting days, deep work blocks, and planning periods—can add up.
    • “Having a planning week per quarter, having a day every fortnight where there’s no meetings, having an hour and a half every day where you just get to do deep work...” (34:58)

Notable Quotes & Moments

• "When we enter the healthcare profession, none of us actually ever go in with an aspiration of productivity or efficiency. It's called healthcare for a reason. We go in because we care."
  —Andrew Bastawrous (03:23)

• "The greatest gift I could give her was not her sight, but to have her be truly seen."
  —Andrew Bastawrous, reflecting on patient Jackie (05:32)

• "People aren't inherently not caring or not compassionate. If the environment is one that doesn't allow people to stop and care, then people don't live to their values."
  —Andrew Bastawrous (05:58)

• "If patients are given more time to be heard and doctors have more time to listen, everyone will be happier and the results will improve."
  —Andrew Bastawrous (08:48)

• "AI is going to amplify human behavior...that could be for good or less good."
  —Andrew Bastawrous (18:06)

• "It's a story about us. It's about what speed does to our souls and how we're constantly, constantly rushing and we miss the kind of obvious, beautiful moments."
  —Andrew Bastawrous, on the Joshua Bell story (25:31)

Timestamps for Important Segments

• [03:23] Entering healthcare: care vs. efficiency
• [04:00]–[05:32] Jackie’s story: presence matters
• [06:58]–[07:56] Scaling Peak Vision: from efficiency back to compassion
• [11:39]–[15:44] Global eye health barriers and technology-driven solutions
• [18:06]–[19:50] AI's risks and opportunities in healthcare
• [21:59]–[25:31] Personal practices for presence; the Joshua Bell anecdote
• [27:23]–[31:23] Early trial findings: compassion yields measurable results
• [32:51]–[34:59] Advice for designing compassionate work/home environments

Closing Reflections

Andrew Bastawrous’s central message is a call to action for both individuals and systems: true success in healthcare—and in life—should be measured not solely by throughput, volume, or efficiency, but by the depth of our connection, empathy, and presence. By redesigning systems and personal practices for slowness and clarity, the outcome isn’t just a happier workforce or more satisfied patients, but a fundamentally more just and humane society.

For further info about the TED Fellows program and more talks, visit fellows.ted.com.