When I joined Mathematica as a senior fellow after working in academia and clinical medicine, it felt like coming home. I was looking for a supportive team-based culture, where people collaborate and share knowledge across disciplines, and I’ve found it here. Mathematica is a place where I can pursue truth in the company of friends. My colleagues do engaging and important work on primary care, comparative health systems, the health workforce, and financing and payment models. Together, we’re asking hard, smart questions and building evidence to improve the health care system and people’s lives.
Even as a kid, I knew I wanted to positively impact the lives of others. My family encouraged me to pursue medicine, and I eventually went to medical school and became a family doctor in a community-based practice in San Francisco. I’m a generalist at heart—I’m interested in the whole person, and primary care was a great fit. I loved being a clinician. There is something sacred about the connection between a primary care doctor and patients. From birth to end of life, you’re with them every step of the way. It was my calling. I felt like I could make an immediate impact on people’s lives and help them navigate the often-frustrating encounters with the health system.
I enjoyed partnering with patients, but I also took a macro view of how to improve health care by conducting research and improving policy. At the University of California, San Francisco, I taught and mentored the next generation of physician leaders. I was balancing several roles including doctor, researcher, teacher, policy-consultant, and mother of three small kids. Eventually, I had to cut back on seeing my patients, because I felt I couldn’t give them what they needed. Then in the midst of this juggling act, I was diagnosed with breast cancer. I went through prolonged treatment, an experience that provided me with the patient perspective and profoundly impacted my thinking about the health system.
For 20 years, my research has focused on answering health policy-relevant questions, funded primarily by philanthropic foundations and the government. It’s work that has an immediate audience and offers potential for immediate change. I’ve been fortunate to lead projects at Mathematica that help state policy makers and other health care decision makers, and our work on graduate medical education in California is an example of how we partner with leaders in state government. This work addresses two issues: the short supply of primary care and psychiatry physicians, and their maldistribution across the state, which impacts access for rural and underserved communities. In partnership with the California Health Care Foundation, we provided the state of California with the evidence they needed to establish a new workforce advisory council. We’re now helping state leaders to institute that council. This critical work is taking place during the COVID-19 pandemic as patients struggle to access care and providers suffer from burnout and exhaustion, putting further strain on health care networks and providers.
The pandemic has exacerbated and exposed these challenges, and addressing them is essential to achieving more equitable health outcomes. I’m passionate about improving the health care system so patients have access to high-quality primary care and primary care providers are better resourced to deliver that care while avoiding overwhelming student debt and the constant threat of burnout. In addition to addressing workforce issues, we’re also working with the California Health Care Foundation on their primary care initiative, helping to position California as a leader in revitalizing primary care broadly speaking and resourcing it appropriately with a strong focus on advancing health equity.
My career has been filled with interesting and exciting experiences at the intersection of primary care, health research, and health policy. I’m happy to have found a “sweet spot” serving as a bridge between primary care and policy research and then helping to make sure the research is translated into policy that impacts peoples’ lives. As a California native and a product of its educational institutions, I’m pleased to be able to apply that perspective and commit my work to improving the lives of Californians. Because California is the largest, most diverse state in the nation, and an incubator for innovative health care ideas, what we do here is relevant and important to other states and the nation as a whole.
