Prior to his work in the administration, he was President and Chief Executive Officer of the Institute for Healthcare Improvement[1] a not-for-profit organization.

On December 2, 2011, he resigned because of heavy Republican opposition to his appointment and his potential inability to win a confirmation vote.

[2] On June 18, 2013, Berwick declared his candidacy for governor of Massachusetts, but lost the Democratic Party nomination to Attorney General Martha Coakley.

[3] Berwick has studied the management of health care systems, with emphasis on using scientific methods and evidence-based medicine and comparative effectiveness research to improve the tradeoff among quality, safety, and costs.

[10] His mother, Rosalind Fine, was the primary caretaker of Berwick and his two younger brothers until she died from ovarian cancer in 1961.

[15] In that position, Berwick investigated quality control measures in other industries such as aeronautics and manufacturing, in order to consider their application in health care settings.

Based on this work, Berwick left Harvard Community Health Plan in 1989 and co-founded the IHI (Institute for Healthcare Improvement).

On April 19, 2010, Berwick was nominated to be Administrator of the Centers for Medicare and Medicaid Services, which oversees the two federal programs.

"[18] For political reasons, the Obama administration didn't want Berwick to defend his past statements on the British health service, spending caps and high-technology care.

[26] Senator John Kerry defended Berwick against "phony assertions" and accused Republicans of trying "to crank up the attack machine and make his nomination a distorted referendum on reform".

[28] Berwick was installed by recess appointment on July 7, 2010, before confirmation hearings were scheduled by the Democratic-controlled Senate committee.

Berwick, who holds three degrees from Harvard, repeatedly emphasized his experience in helping health organizations deliver better care to consumers, an asset he said he would bring to being the state’s chief executive.

[34] Some of Berwick's specific goals for the governorship included focusing on job creation and economic development, instituting single-payer healthcare in Massachusetts, and ending child poverty in the state by the year 2024.

While at Harvard, Berwick met his future wife, Ann, in his freshman biology class, where they were lab partners.