Alumni in Public Service
The Art of Patience
Bill Frist, former United States Senator from Tennessee, Senate Majority Leader, 2003-2007.
A career in medicine offers one reward that trumps many others: The knowledge that, whether clinician, researcher, or academic, there’s a clear path to getting things done—a patient diagnosed and treated, time in the lab that yields progress, a teachable moment for a student. Not so clear a path for Stanford University School of Medicine alumni who add public service to their resume. But according to some of these dedicated public servants, the effort can be worth the delayed gratification.
Here’s one political reality: The quick fixes are few and far between. Unlike medicine, there are no one-on-one life or death issues addressed in a moment, with experience, instinct, and skill. Instead, there is slow progress to serve the needs of many. There are challenging relationships that must be nurtured for the glimmer of a positive outcome. And ultimately, there is putting faith in the possibility of making a difference.
Bill Frist was a former Stanford senior fellow and chief resident in cardiothoracic surgery before choosing a life in politics that eventually led to service as Senate Majority Leader.
“The engagement of a patient with the doctor leads to a satisfaction that is above all others,” says Frist. “There is an immediacy and intimacy that just can’t be matched... the personal and immediate satisfaction when you work with patients is the best. When you go home at 10 at night from the hospital you know with certainty that you have helped someone. When you go home at 10 at night from the Senate, sometimes you wonder if you have accomplished anything.”
“As a physician you impact one life at a time. Here [in state government] you can impact thousands at once. It’s a different set of rewards.”
Dan Foster, West Virginia State Senator
From Helping Few to Helping Many
There’s a passion shared by those alumni who pursue public service—the passion to serve. Despite the inherent frustrations of the slower pace, they see an opportunity in public service to help more people at once than is possible as a practicing physician.
After serving as a general surgeon from 1979 to 2002, Dan Foster won a spot in the West Virginia House of Delegates and two years later was elected to the West Virginia State Senate. His medical background makes him a passionate advocate for health care issues, including tobacco control, childhood obesity, malpractice reform, and controlling the cost of prescription drugs. He found that “the positive is the far-reaching impact you can have. As a physician you impact one life at a time. Here you can impact thousands at once. It’s a different set of rewards, but it is rewarding.”
Senator Frist echoes this thought: “I ran for the senate because of a burning desire to take that commitment to heal one on one, and work to heal many. PEPFAR—the President’s Emergency Plan for AIDS Relief—is a great example of this. With a single piece of legislation just three paragraphs long, we saved 10 million lives over 10 years.”
Peter Arellano returned to his roots in Gilroy after earning his medical degree and has now served for nine years as a city council member.
“ As a physician coming back to my hometown, I was automatically placed in a leadership role,” says Arellano. “ You can choose to be that leader or refuse. I started volunteering in many roles. Once my children were grown and away at college, I had more time to volunteer and found myself getting involved in politics.”
Arellano’s motivation intensified when he was confronted with the ways the environment was affecting his patients.
“I wanted to be able to do more than I could do in my office,” he says. “For instance, I could treat a child’s asthma, but I wouldn’t be able to stop the asthma attacks if they were caused by pollution from a factory down the road or because they live near the highway. Many patients came to me with problems from drinking contaminated water in Morgan Hill. That made me want to be more involved in policymaking.”
Jacob Eapen is a pediatrician for Alameda County Medical Center and has held several elected and appointed roles, influenced by his early training in India, Tanzania, and Nigeria. He says the call to public service can be compelling.
“If you’ve got a passion to serve, there’s not too much transition from being a physician to holding public office. It just gives you the opportunity for greater impact.”
In fact, what Eapen saw every day in his patients’ experiences drew him to his current position on the board of directors for Washington Township Hospital District.
“I work for Alameda County and the patients I see are the underinsured or the uninsured. My goal is health care reform because I am really on the front lines. For my uninsured patients, it’s virtually impossible to refer them to a specialist. Since I can’t change the world, I ran for the board because I thought it was the best I could do for my patients in a small setting. I could be their advocate, maintaining the quality of the hospital. There was no public health expert representation on the board, and I thought I could provide that.”
“I wanted to be able to do more than I could do in my office. For instance, I could treat a child’s asthma, but I wouldn’t be able to stop the asthma attacks if they were caused by pollution from a factory down the road or because [the child lives] near the highway. That made me want to be more involved in policymaking.”
Peter Arellano, Gilroy city council member
“Since I can’t change the world, I ran for the board because I thought it was the best I could do for my patients in a small setting.”
Jacob Eapen, pediatrician for Alameda County Medical Center
New Game, New Rules
For Jean M. Duffy, it was an adjustment to move from a role as a community health nurse to serving as an elected official.
“Politics is hardball,” says Duffy. “That was the toughest point of transition. You’d like to think it’s collegial and everyone is nice, but that’s not the reality. There’s always going to be someone waiting to take you down, and there will always be some tough votes, or votes where you have to give yours to get theirs to get anything passed. You really need to develop a thick skin.”
Philip R. Lee, now a consulting professor for the Stanford Program in Human Biology, brought a lifetime of health leadership to the table. He spent four decades in policy and senior counsel roles under presidents from Lyndon Johnson to Bill Clinton. For Lee, navigating the world of politics required an ongoing commitment to learning.
“The greatest challenge in moving into government was that there was so much to learn,” he says. “Working in the Agency for International Development, I had to learn about malaria, tuberculosis, nutrition, family planning, and diarrheal diseases. The topics were so much broader than those encountered in my practice. But it was great to be learning again.”
Stanford Provides the Spark
Although most of these public servants pursued medicine without politics as a destination in mind, Stanford proved to be a valuable training ground for all. “My time at Stanford really had a defining impact on my life,” says Frist. “I left the traditions of Boston because they had rejected innovation there, and I literally went west with all of that spirit you read about in history, to be at the most creative, innovative, and dynamic place. If I had stayed in Boston, I’d probably still be there today, never having left a straightforward medical practice. I wouldn’t have had the confidence to take the risks I have.”
Arellano shared an appreciation for the open environment at Stanford. “Stanford offered me the flexibility in my schedule to serve on a student health committee,” says Arellano. “We talked about how to deal with health care in the community, the nursing shortage, how to get students more involved. It was a chance to make a difference in the community and I wouldn’t have been able to do it without the flexibility Stanford provided.”
Duffy’s self-assurance seems rooted in the same experience. “One thing I carried with me into the legislature was the mantra I heard in school: If you are a Stanford nurse, you can work anywhere,” she says. “In a million years if you had told me then I’d become a politician I wouldn’t have believed it. But the principles I learned at Stanford about public health nursing served me well. It is all about meeting people where they are. Our faculty taught us to work with people in their own environment. In politics, that’s just like working for your constituents.”
For researchers, it turns out that the process of discovery can be a model for thoughtful public service. There may be few jobs in contemporary society that require as much patience as serving on community school boards. But Sally Stewart, a school board member for over 38 years, including more than 28 with Sequoia Union High School District, found her Stanford training good preparation.
“What served me best in public service was my research training,” she says. “I approach much of the school board work with the same process I learned as a student: listen, read, learn, then form a hypothesis. Next, I would test my hypothesis by talking with various people and from that I would form my opinion.”
Advocating for Others to Follow
Another passion shared by alumni who pursue public service is the passion to encourage other medical professionals to follow in their footsteps.
Eapen is something of an evangelist for encouraging medical professionals to run for elected office. “Change comes from policymakers. If you want to see change in health care, you need to get involved on that level.”
Senator Frist agrees. “I was the only doctor or medical professional in the Senate in the last 50 years and it’s 16 percent of our economy! In the 50 years before that, there were 7, and 14 in the 50 years before that, and 26 in the 50 before then. The decrease over time is a concern. I encourage anyone who is willing, to make the commitment, because there is not a more noble profession on earth.”