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Baltimore Health Commissioner and Patient Advocate

leanawen077Leana Wen, MD, MSc is the Baltimore City Health Commissioner and an emergency physician, public health leader, and patient advocate. Since her appointment in January 2015, Dr. Wen has led implementation of the citywide opioid overdose prevention and response plan, and in the wake of the city’s civil unrest in April, she directed the city’s public health recovery efforts. Most recently, Dr. Wen has been an attending physician and Director of Patient-Centered Care in the Department of Emergency Medicine at George Washington University. She is the founder of Who’s My Doctor, a campaign calling for radical transparency in medicine, and co-authored the book When Doctors Don’t Listen: How to Avoid Misdiagnoses and Unnecessary Tests. Dr. Wen received her medical training from Washington University School of Medicine in St. Louis and Brigham & Women’s Hospital/Massachusetts General Hospital in Boston. She studied public health and health policy at the University of Oxford as a Rhodes Scholar, and worked as a community organizer in Los Angeles and St. Louis. She has served as a consultant with the World Health Organization, Brookings Institution, and China Medical Board; an advisor to the Patient-Centered Outcomes Research Institute and the Lown Institute; and as national president of the American Medical Student Association and American Academy of Emergency Medicine-Resident & Student Association. In 2007, she was selected to report with Pulitzer-Prize winning columnist Nick Kristof in Rwanda, Burundi, and D.R. Congo, where she wrote on the health consequences of war.

leanawenbookI started following Dr. Wen’s work when I read this moving personal piece she wrote for Health Affairs, where she confronts the stigma against patients—and providers—with disabilities. I reached out to Dr. Wen after she became commissioner of health for the city of Baltimore in January to learn more about how she has followed her passion for patient safety and public health within her medical career.

V: As someone with so many different talents, what drew you specifically to medicine?

Dr. Wen: I was ill as a child, and I also grew up in an area with profound health disparities. I saw the effect of poverty on health, and how closely health is tied to so many other things, including unemployment, lack of housing, and lack of education. I wanted to make a difference in people’s lives and help them live to their full potential.

V: Going into medical school, did you know you wanted to do emergency medicine?

Dr. Wen: Not at all. From my personal experience, the majority of my classmates changed their minds about what they wanted to do after they started medical school, which is totally fine—and to be encouraged—because you will have all these new experiences in medical school, and you should embrace them rather than have a fixed idea of what it is that you had wanted to do. You don’t really know until you’re there what you’ll enjoy and what you won’t. So I highly encourage people to keep an open mind.

V: I read a recent article of yours where you talk about why you transitioned from being an ER doctor to being the health commissioner for Baltimore. You mentioned that as a medical student, when you saw a patient and you really tried to go into the social aspects of what was behind her illness, a senior physician said: “It’s not your job to open Pandora’s box.” Is that a sentiment you encountered a lot in medical training?

Dr. Wen: Absolutely, and that is part of the disillusioning aspect of medicine. I believe that the vast majority of us go in for the right reasons, but then we find many barriers that we have difficulty overcoming. It’s important for us to figure out how to not lose our idealism. The way to do that, I believe, is to keep strong to why it is that we considered it in the first place. Keep strong to what you love and being part of the community, and don’t let go of that.

V: Do you have any specific things that motivate you and that you hold onto to keep strong that ideal?

Dr. Wen: Many times in medicine, people will say to you that there is one way of doing things, and this is the one path that you have to follow. You should resist that, because there are many paths to get at the end goal, which is helping our patients and helping our populations. You have to pass medical school, so I’m not suggesting that you don’t study, but rather that taking time off is totally fine. I took four years off from my medical training, and I don’t regret a minute of it. It’s important to follow your heart about what it is that you want to do, and whatever that is—whether it’s writing, or art, or technology, or community organizing—all of that will make you a better doctor at the end of the day.

V: In your current role as the commissioner of health for Baltimore, what does a normal day look like?

Dr. Wen: There is no such thing as a regular day. Every day is completely unpredictable and that’s because I run an agency of over a thousand employees who do such a large and wide variety of activities, ranging from animal control and restaurant infections to prevention of communicable diseases, to home visiting for pregnant moms, to home visiting for seniors, to serving meals for seniors, to preventing childhood obesity, to dealing with mental health and addiction. Because of the diversity of our services, I spend a lot of time meeting with our city council, the mayor, and state legislators. I also spend time implementing programs on the ground, and working with our constituents and our residents. We run two clinics, which I work in, and we are active in a number of projects across the city.

V: When you think back to your own medical training, did it include advocacy as a part of what you learned as a medical student or resident? Do you think that medical education can include more on public health and advocacy?

Dr. Wen: Physicians are the natural advocates for our patients, and public health is medicine on a larger scale. We should absolutely be teaching these skills in our medical training, and we’ve gotten better in the last 10 to 15 years about incorporating health policy and public health into medical education, but most students are not going to be attending schools that do a particularly excellent job at this. So I think in the interim, there’s a lot that you could do yourself. The way to do it is not study it, the way to do it is to do it. Work in the community. Don’t just think about the position that you’ll have, but think about the work that you’ll be doing, and do the work.

TedmedV: I know you give a lot of speeches and TED talks, and you’ve written and talked about how you used to have a stutter while growing up. I was wondering, how did you transition into becoming such a strong public speaker? Do you have any tips for people who might be facing similar challenges? 

Dr. Wen: I think for me, the critical part is overcoming my shame, and acknowledging that I am a person who stutters. Facing that identity is critical to overcoming the barriers, because shame is the underlying factor for fear, and you have to overcome shame in order to overcome fear that one might face.

V: Do you have any tips for being creative as a doctor in your career?

Dr. Wen: I would give three general tips. The first is, don’t let people tell you that it can’t be done. Whatever it is that you want to do, there is a way to make it happen. Number two is closely related, which is, sometimes you have to take time off. Whether it’s not studying that particular night, taking a weekend off, or even taking a year or two off from your normal path, it’s okay. That time will give you better perspective and will allow you to be a better thinker. The third thing is, don’t look for a position, because a particular position will mean nothing. What you really need is to figure out what it is you can do in that position.