Looking ahead

He’s an economist, a researcher, and a physician, and he’s about to become provost. On the day (April 15) that President Drew Faust announced that he would be Harvard’s next provost, Alan M. Garber ’76 sat down with the Gazette to talk about his career, his new role, and facilitating connections across traditional academic boundaries as the University evolves for the 21st century.

GAZETTE: Welcome back to Harvard.

GARBER: It’s a great pleasure to be back.

GAZETTE: Let’s start with the past. Is there a single memory that crystallizes, for you, the Harvard experience? What do you tell people when they ask what it was like to be a student here?

GARBER: I’ll tell you something that touches upon the health system, advising, and the importance of mentorship. I started out as a biochemistry concentrator, and in my first year at Harvard, I discovered I loved Physics 12 and Ec 10, two courses that I’d taken out of general interest. The following year I moved into Dunster House, and the resident tutor in economics was getting, in addition to his Ph.D. in economics, a J.D. We became friends, and we talked a lot about courses, my interests, and so on. He told me that I was crazy to continue in biochem. I loved economics so much, I should switch. He told me which courses I should take, and he said I should become a research assistant for a professor, which he then arranged for me.

That set my entire career on a very different path from the one I started down. If there is one thing that might not have happened anywhere else but at Harvard, it was this. My life changed dramatically and for the better.

GAZETTE: Let’s talk about your career. I understand that you are the founding director of both the Center for Health Policy and the Center for Primary Care and Outcomes Research at Stanford, and you spent nearly two decades as the founding director of the health care program of the National Bureau of Economic Research.

GARBER: My entire career has focused on application of the tools of economics to the important problems in health and health care in the U.S., along with other nations. A lot of what I’ve done is what’s called cost-effectiveness analysis, or decision analysis, or sometimes technology assessment. This research aims to improve the efficiency of health care — identifying the best health interventions to use. It is only partly about learning what works best. It’s also about figuring out which forms of care offer the greatest value. My interests have ranged from basic methodology to evaluations of specific interventions, such as treatments for prostate cancer.

Although these kinds of studies are routinely adopted for health care decision making around the world, the premise that value should be a criterion for adopting health care interventions is controversial in the United States. So the impact of this type of work in the United States has been more limited than many of us hoped or expected.

GAZETTE: You’re also a physician, and you work with medical residents. What’s your area of specialty?

GARBER: I see general medical patients at the VA Palo Alto Health Care System.  Five, six, seven years ago I would have told you the vast majority are elderly. Now there’s quite a mix, with returning veterans from Afghanistan and Iraq. Many of them have chronic medical problems. It has been a very rewarding and gratifying experience. The patients are generally grateful for the care that they receive, and, unlike research, at the end of a visit you can feel as though you’ve really done something. The payoffs to research take much longer. Having this near-term gratification has added an extra dimension to my career that I really enjoy.

GAZETTE: Will you be able to continue your clinical work after you take on this new role?

GARBER: I expect that any medical care that I deliver will be informal, not billed, and not part of my job description. (Laughter)

GAZETTE: So why this job now? You have your research, you teach, and you have your clinical practice. Why become provost of Harvard?

GARBER: I can assure you that I never set out thinking, let me see if there’s an opening for a provost. My academic activities have been deeply satisfying, and I have a great set of colleagues. Everything about my job right now is as good as it could be. But when Drew approached me to think about this position, it reminded me of how deeply I care about Harvard, how important its mission is, and how much potential there is to make a real difference in higher education by contributing to the University. The most important aspect, though, is the opportunity to work with Drew.

GAZETTE: I imagine that you spent quite a bit of time with her while you were considering this job. What are your impressions of her?

GARBER: Drew is a leader who has gathered around her a very impressive set of staff and deans, and while she may express her vision in low-key ways, I believe that in the years to come she will be remembered as the president who brought Harvard together to make the whole much greater than the sum of its parts.

GAZETTE: What will it take to achieve that?

GARBER: To put it in broad terms, it will include turning Harvard into the best Harvard for the 21st century. That will take many forms. It will mean enabling the different parts of the University to work together more easily, more effectively. It will mean strengthening the University’s financial position. And it will mean continuing to do what it has always done best — attracting the very best people in the world — but at an even higher level.

GAZETTE: Those are lofty goals. What do you see as your role in working toward them?

GARBER: My role is to assist Drew in that effort. My particular responsibilities, I expect, will range from deep involvement in the appointments and promotions process for faculty. It will also involve responsibility for a number of interdisciplinary initiatives, including, for example, the libraries; I will chair the new Harvard Library Board. One of the responsibilities that greatly excites me is the provost’s role in planning the Allston campus, which I think represents an opportunity to shape the University of the future.

GAZETTE: It’s worth pausing on those two issues. They will undoubtedly be major areas of focus as soon as you come aboard in September. From what you have seen so far, what do you think of the transition under way in the library system?

GARBER: When you have a library system as magnificent as Harvard’s, the first thing you want to consider is a paraphrase of a basic principle of medicine: Above all else, do no harm as you make changes. But maintaining the status quo is not an option. The very definition of a library has been changing. This process is about preparing for the library’s future by establishing a more closely coordinated management structure and improving delivery of service to patrons. I’m excited by the work that’s already been done by the various groups that have been assessing the library system. I think they have done a tremendous job of outlining the challenges and coming up with a plan for the path forward. Now it’s a matter of working out the details, and I look forward to participating in that process.

GAZETTE: What do you see as Harvard’s future in Allston?

GARBER: My starting point, as I get ready to assume these responsibilities, will be the report coming from the Work Team on Allston this summer. I anticipate that the report will address a number of issues, and that I will then need to engage in discussions widely throughout the University to get a better understanding of the needs that might be addressed by developments in Allston. I expect Allston to be a hub that brings together interdisciplinary initiatives in a way that involves the community broadly.

GAZETTE: A hub for interdisciplinary initiatives — there has been increasing emphasis placed on removing barriers to collaboration across the Schools and academic disciplines in recent years. Do you see that as a key part of what will define Harvard in the 21st century?

GARBER: I do. I quickly noticed, as I engaged in discussions here, that some things have changed dramatically since I was a student — and you have to keep in mind that I’ve maintained contact with the University continuously throughout those years, including service on the Committee to Visit the Medical School and the School of Dental Medicine. Take, for example, the Wyss Institute and the Stem Cell Institute, along with the Department of Stem Cell and Regenerative Biology. These are remarkable accomplishments. Fifteen years ago people would have been skeptical that Harvard could successfully pull off a set of cross-cutting activities of this scale and quality. These changes have been especially dramatic in recent years, and I attribute this to Drew’s leadership, the deans, and the work of [outgoing Provost] Steve Hyman. Steve has been responsible for making interdisciplinary initiatives like these work. He deserves great credit for his role in moving them forward so successfully. My role will be, in part, to carry on what he has started.

GAZETTE: As provost, your purview will of course extend beyond your academic areas of expertise. Where do the arts and humanities fit into your ideas about interdisciplinary work?

GARBER: First of all, like virtually every educated person I know, I have a personal interest in the humanities, in terms of what I read, what I do, …

GAZETTE: What are you reading right now?

GARBER: Right now I’m reading a book by Kwame Anthony Appiah, a former Harvard faculty member, now at Princeton, called “Experiments in Ethics.” He’s a philosopher, and part of what he argues is that a philosophy of ethics needs to be grounded in what we really know about human nature, the findings of psychology, experimental philosophy, and other fields that fall outside the realm of traditional philosophy. The beauty of his approach is that it demonstrates not only how the sciences can inform the humanities, but how the humanities can inform the sciences.

GAZETTE: Cross-pollination between the humanities and the sciences — that sounds like the kind of synergy that Harvard has increasingly been trying to encourage since the Task Force on the Arts report was released a couple of years ago.

GARBER: The task force report made a very eloquent and persuasive statement about the role of the arts in the life of the University. When you look at Harvard, with its abundance of arts-related extracurricular activities and tremendous student involvement in those activities, you would never think of the arts as marginal to the life of the University. But this report made the case that such efforts often seem ad hoc and not fully integrated into the curriculum, into the so-called serious side of college and university life. I suspect that many of these observations apply across the humanities, too. There is so much that the humanities have to contribute to the life of the University, not just for entertainment and general enrichment, but to actually add to the value of the research and teaching in other fields, in other areas.

Think about computing. When the original Apple Macintosh was introduced, it was remarkable in part because it displayed beautiful typography and proportionally spaced fonts. Its interface was far advanced beyond anything that had previously been seen. Steve Jobs said that he insisted on having this kind of functionality because he had taken a calligraphy course when he was younger, and it made an impression on him about the importance of design elements, about how different a document could look when it was printed in a beautiful font.

The many ways in which the humanities and the arts can inform what we do in science, technology, in many different fields, are just tremendous, and we often don’t notice them.

GAZETTE: Tell us a little bit more about yourself. You will be bringing a family with you to Cambridge?

GARBER: Yes, I have a wife and four children. The youngest is a fourth-grader and the oldest is a sophomore in the College. My wife is an oncologist. I met her when we were residents together at Brigham and Women’s Hospital. I carried her off to the West Coast, and now I’m about to carry her back. (Laughter)

GAZETTE: What do you do when you’re not crunching numbers or reading? Any hobbies? What do you do to keep in shape?

GARBER: I’m trying to decide whether to describe myself as a former marathoner or a current marathoner. I’ve suffered through more than my share of injuries, so probably shouldn’t keep running long distance. But I have to tell you, the Boston Marathon is three days from now, and as I see the runners milling around here, I feel envious. So you might call me a recidivist runner.

GAZETTE: You can join the Harvard on the Move program and get right back into shape for next year’s race. (Laughter)

You’re originally from Illinois, and you’ve been out in Palo Alto for 25 years. But you also lived and studied here in Cambridge. Does that make you a Cubs, Giants, or Red Sox fan?

GARBER: You know, I’ve always had a soft spot for the underdog. Red Sox all the way.