Tell us about your current job role and employer. What are you currently working on?
I currently serve as the Deputy Commissioner for Population Health with the Tennessee Department of Health. Our Department serves as the state public health agency and we have a mission to protect, promote and improve the health and prosperity of people in Tennessee. We are focused on the “Big Four”—factors that are driving Tennessee’s poor health rankings as well as taking years from our lives and lives from our years: physical inactivity, excessive caloric intake, tobacco/nicotine dependence, and other substance use. In public health, much of our work is “upstream,” distinguishing us from traditional health care. Rather than focus on treating you once you are sick, our aim is to prevent disease before it ever happens. Another distinguishing characteristic of our work is that our “patient” is the entire population—so we are always thinking about how the work we do can impact the health and well-being of 6.6 million Tennesseans. Current priority areas for me include thinking about how we make public health data more available and in a more timely fashion to influence programming and policy at all levels (local, state, and national); exploring ways to operationalize and measure the concept of “population health;” and thinking about how we adapt our public health infrastructure to incorporate advances in technology and to meet the population health challenges of our time (which have largely moved from infectious diseases to chronic diseases).
What key personal and/or career experiences led you to where you are today?
As a third year medical student, I was rotating through my pediatrics clerkship and actually had the opportunity to shadow my own pediatrician, Dr. Mac Herring (a Wake Forest medical grad). I remember walking out of an exam room after a particularly challenging visit, and Dr. Herring turned to me and said, “Michael, you have to be an advocate for these children and families. No one else is going to do that.” That advice struck a chord within me and caused me to look more broadly at the opportunities that physicians have to improve health, many of which are outside of the clinic or hospital. In medical school and residency, I was fortunate to have mentors who introduced me to ways that physicians could engage systems to influence health policy. When I finished my residency, I pursued a Master’s in Public Health, during which I completed a public health practicum. I worked alongside one of my mentors in the Tennessee Governor’s Office of Children’s Care Coordination and with colleagues in public health and Medicaid on a variety of issues aimed at improving the health of children and families. Those experiences gave me a better understanding of how to navigate the state government and health policy landscape, and in 2010, I was fortunate to join the Tennessee Department of Health as Director of Maternal and Child Health. Over the next few years, I assumed additional responsibility for efforts related to chronic disease prevention and health promotion, and most recently I was appointed as Deputy Commissioner for Population Health.
What is the most challenging aspect of your job? How do you navigate that challenge?
One of the most challenging aspects of this work is a relative lack of resources. While we devote a tremendous amount of resources to health care in this country, the amount that we pay for public health and primary prevention services pales in comparison. So there never seems to be enough money to do what we truly need to do. And yet there are still ways to get things done. I think back to my WFU days and community work through the Volunteer Service Corps—we formed partnerships with folks who had resources to help us accomplish a goal. In the same way, our teams work every day with partners across the health spectrum to combine our efforts in pursuit of a common mission. Another very real challenge is thinking about how to communicate science, especially when those messages are nuanced, to a broad variety of audiences. Because I work in a government setting, there is often mistrust about what we are saying and why we are saying it. I have been fortunate to have strong mentors who have constantly reminded me that it is important to engage folks—even if they disagree with you—and work to find the places where you agree and work from there. Understanding their concerns and, where possible, addressing those as you formulate a response—can be incredibly powerful. That engagement builds trust, and even if you don’t ultimately convince others to see the world exactly as you do, they may be able to better understand your perspective (and vice versa).
What advice would you give to Wake Forest graduates about developing their personal life habits after college (finances, health, values, work/life balance)?
I’m probably not the best person to give advice on work/life balance, although I’m trying to get better! I think it is very important to find those things that help keep you grounded, and make those a priority. Whether it’s time with a significant other, or a particular hobby, or being active, make explicit time for that. I remember thinking that early on in my career that I needed to put all of my effort into my work and then make time later for all those “nice-to-do” things that help keep me grounded. While well-intentioned, that pace is absolutely not sustainable (at least not with any desire of maintaining your health or meaningful relationships with others), and it is hard to find time “later” once the schedule is completely booked. Build in time for you (and your loved ones) early on, and make it a priority. That may mean deliberately blocking your calendar for those things. Don’t believe people when they say that you will find time to “work it in” later!
We know that relationships are important for any kind of development. How do you build and maintain your network?
One of my favorite leadership books is “The Five Dysfunctions of a Team” by Patrick Lencioni. In that book, Lencioni describes how teams can work together to achieve success. At the root of those efforts is trust, which creates an environment where individuals feel comfortable sharing their ideas and their emotions. When that is able to happen, a group of people can have “healthy conflict” and commit to an idea based on the “wisdom of the group” rather than one individual. Those ideas are almost always better than the one that any single one of us originally had. On the teams with which I work, I try to create that environment where individuals feel comfortable and empowered to share their ideas.
I also like to think about all the stakeholders that are involved in a particular issue and be sure that they are engaged. That is rooted in a dual desire to 1) get their input so that we can end up with a better product (see above), and 2) to identify what resources we each might bring to bear to address a challenging issue (in a time when resources are usually limited).
Tell us about your mentoring relationships. What impact have these relationships had on your career and life?
I’ve been fortunate to have strong mentors throughout my life. At Wake Forest, my undergraduate adviser was Dr. Christy Buchanan in the Department of Psychology. I learned so many things from Dr. B—not the least of which was how to write well. I have a mug on my desk that says “I’m silently correcting your grammar” that is a testament to my time in her courses. (If she’s reading this, I hope that I don’t make any mistakes!) More importantly, she exposed me to key concepts in developmental psychology that I still use today. Another mentor in Psychology was my honors advisor, Dr. Debbie Best. Debbie always seemed to be able to have a sense of where I was going or could be going (even when I didn’t) and encouraged me to think beyond my first plan for myself and explore what really made me happy, both professionally and personally. During residency, I was exposed to pediatricians who helped to shape my path. Dr. Veronica Gunn helped to show me career path options outside of those that are typical, and Dr. Rebecca Swan helped me to carve out learning experiences during residency that would help prepare me for this somewhat unique career path for a pediatrician. Once I moved to public health, I was fortunate to have a series of supervisors and colleagues who have continued to mentor me. Dr. David Reagan taught me the value of staying in a position 5-7 years “so that you can learn to live with the decisions that you make,” one of the best pieces of advice I have ever been given. Each of these mentors, along with others, has helped me to ask the difficult questions needed to clarify my path and have been the source of invaluable “cheerleading” all along the way.
What advice would you give to current Wake Forest students and/or young alumni who are interested in working in your industry?
First, the kinds of things that make you successful at Wake Forest—discipline, intellectual curiosity, and integrity—will absolutely make you successful once you leave. The hours can be long and the days can sometimes be frustrating, but when you look back after a few months, or a few years, you realize that you’ve been able to “move the needle” on issues that will ultimately make the population healthier. Doing that work with integrity, especially if you are in the public sector, will help you avoid distractions that can derail even your best efforts.
Another bit of advice would be to always be willing to work across disciplines and with people who have differing viewpoints. In very few circumstances will you be able to succeed by only working with people who think in the same “bubble” as you. Exploring the diversity of opinions around an issue and involving others early on in the process will assure that you come up with solutions that are much better than you could have devised on your own.
What’s next for your career? What future goals or plans are you pursuing?
I was in my previous public health role for about five years before moving into this current role two years ago. So I’m following the advice of one of my mentors and thinking about what lessons I learned from my successes (and more importantly my failures) in the last five years and applying those lessons in this current role. I do miss clinical pediatrics, and I am currently working on some opportunities to build back in a little bit of clinical time to help keep me grounded (and because who doesn’t want to make toddlers laugh!). I really do love the work I am doing currently and the new challenges that come each day. I don’t have any moves planned in the short term—I would hope that future roles would continue to satisfy my calling to serve and to do so in the context of improving the health and well-being of populations.
Story published in March 2018. For current updates about Michael, visit his LinkedIn page.