GOVERNMENTBringing in the private perspective: From a children's clinic to state governmentA Washington state pediatrician draws on her real-world medical experience to help her do the most good in the public health arena.By Tanya Albert, amednews staff. Nov. 18, 2002.
The Nation is their Patient
Doctors serve America at all levels of government. This occasional series explores how their medical background influences what they do. Sometimes just one phone call can transform a career. In 1988, pediatrician Maxine Hayes, MD, MPH, was serving as the medical director for the Odessa Brown Children's Clinic, an affiliate of Children's Hospital Medical Center in Seattle. She thought she had found her niche in her chosen field of public health. She already had a long list of accomplishments -- from helping to build a 12,600-square-foot clinic in a medically underserved area of Brandon, Miss., to working as a physician adviser for the Centers for Disease Control and Prevention Advisory Committee for Immunization Practices.
But then the call came. The Washington State Dept. of Health asked her to help promote passage of legislation to improve access to care. Her answer -- yes -- launched her on a new career path that has culminated in her current position as Washington's top health officer. It's a career evolution she never would have predicted. When she first started with the state health department, she thought of herself as on loan from the children's clinic and believed she would go back. But after the legislation passed, she stayed on to manage a statewide system of preventive health services administered by 155 local health agencies. She helped with maternal and infant health issues, child and adolescent health issues, and family planning, newborn screening and nutritional services. She was named state health officer in February 2000. "I was not planning on staying in state government," Dr. Hayes said. "But once I got into it, I discovered you could do so much for so many people." Dr. Hayes' position takes a special personality. She talks with physicians, policy-makers, lawmakers and patients to find out how the state can best meet its public health needs and do it in a way that is reasonable for physicians and within state budget limits. "I try to bridge the world between the private and public sector," Dr. Hayes said. "And I try not to get too far from the real world." Her real-world perspective lets her offer the state the physician's view on how policies that look good on paper may not work in the trenches. "Maxine is passionate about what she does," said Mary Selecky, secretary of the Washington State Dept. of Health, who has known Dr. Hayes since 1988. "She's very well-respected and well-known in Washington state and at the national level. She's personally on top of issues and helps all of us to understand them from a physician's viewpoint." And Dr. Hayes works hard to maintain her physician's vantage point. She is still on staff at Children's Hospital, she's heavily involved with the Washington State Medical Assn. and she's a clinical professor of pediatrics at the University of Washington School of Medicine, Seattle. She's also on the faculty of the university's School of Public Health. Her involvement has earned her respect from colleagues. "Maxine always comes to physician meetings," said emergency physician Nancy Auer, MD, past president of the WSMA who has known Dr. Hayes for a decade. "She's very focused on public health and what is best for the patients. She's a can-do person. She's upbeat and enthusiastic, even when the budget is being slashed." Dr. Hayes' understanding of how long it can take to pass new health programs and get them implemented and her knowledge about the state budget also helps her when talking to physicians about what the state can do for health care. People, not politics"Until you've been in both worlds, you don't realize the time it takes to evolve good policy," Dr. Hayes said. "On the outside, you ask, 'Why don't they do x, y and z?' But it is really not that easy to change the system. You have to develop relationships with people. It's people that change the system. Not policies." And those interpersonal relationships are something Dr. Hayes does well, colleagues say. "She has the ability to walk in many circles," Selecky said. As Washington -- like so many states -- faces budget shortages, Dr. Hayes is working to defend some of the programs she helped implement, and she's still fighting for new ones to continue improving residents' health. As she has for many years, Dr. Hayes continues to fight for safe drinking water in the state. Since the 2001 World Trade Center and anthrax attacks, she has led the state's charge in preparing for bioterrorism. The self-described fitness enthusiast also has taken on the battle against obesity. She led a walk in 90-degree heat in Moses Lake, Wash., this summer as that town tried to motivate residents to adopt healthy habits, Selecky said. "She's a slight person, but one of the strongest. She's very likeable and clearly leaves an impression," she said. Role modelDr. Hayes' work has been recognized many times. Earlier this year, she received the American Medical Association's 2002 Nathan Davis Award for Outstanding Government Service. She also was awarded the Stockton Kimball Award, the highest peer-generated award from the State University of New York. In 1999, her medical school alma mater, the State University of New York at Buffalo, recognized her as the Distinguished Alumna of the Year. "She's been a great role model for all people because she's so focused on issues and good at making a persuasive argument," Dr. Auer said. Although the results of her work aren't usually as immediate as they were in private practice, Dr. Hayes said she loves the opportunity to make a difference on such a broad scale. "In the office setting, you have closure at the end of the day," Dr. Hayes said. "Here you don't have the same closure, but you make incremental progress. You keep plodding along to accomplish something. It's been a humbling experience." ADDITIONAL INFORMATION:Maxine Hayes, MD, MPHPosition: State Health Officer for the Washington State Dept. of Health
Copyright 2002 American Medical Association. All rights reserved.
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