My Year as a White House Fellow
by Kisha N. Davis, MD, MPH
Note: MAFP is proud of its President-Elect Dr. Davis who, after a strict and competitive application, was chosen to participate in the 2011-2012 class of 15 White House Fellows. As her year of service is now complete, she has kindly agreed to write of her experience.
My journey to the White House Fellowship began about this time two years ago. I had a new baby, a new house, and was soon to get a new Masters in Public Health. I had spent my time since residency at a community health center, living my dream doctor job: seeing patients from birth to death with a broad range of ethnic and socioeconomic backgrounds. A place where I could help the poor, but still felt comfortable referring my friends to be patients there. I often tell the story of the day I saw a diabetic homeless man who lived in a tent in the park and a woman who had just returned from spending the summer on a sail boat with her family in back-to-back visits. I was happy to be using my skills and felt like I was being true to the doctor I wrote about in my medical school essays. At the same time I felt like something was missing. I felt like I wasn’t doing enough to help my patients.
The Affordable Care Act debate energized and reminded me that much of what affects my patients’ health actually occurs outside of the exam room. Can they afford their co-pays and medications; is there a specialist that will take their insurance; is their neighborhood safe enough to get the walking I am recommending; are they educated on a healthy diet and, if so, can they find fresh fruits and vegetables in their neighborhood? At the same time it became more and more clear that family physicians were becoming a dying breed. Working as an employed physician at a Federally Qualified Health Center protected me from some of the payment difficulties my colleagues were facing. However, as I became more active with MD-AFP and AAFP I realized how burdensome private practice was becoming. With these tensions in mind I pursued the White House Fellowship as a way to better understand the federal government so that I could be a better advocate for my patients and the profession of Family Medicine.
The President’s Commission on White House Fellowships was created in 1964 under President Lyndon B. Johnson. The intent is to draw individuals of exceptionally high promise to Washington for one year of personal involvement in the process of government. In return for the Fellowship year, President Johnson expected the Fellows to “repay that privilege” when they left by “continuing to work as private citizens on their public agendas.” He hoped that the Fellows would contribute to the nation as future leaders. The central tenets of the program are education, leadership, and service.
My colleagues and I experienced leadership through our placements, having the opportunity to interact with leaders at the highest level. During my time at the US Department of Agriculture (USDA) I attended regular senior policy meetings with the Secretary and Undersecretaries and gained a better understanding of the personal dynamic that comes into play in government. My experiences at USDA ranged from touring a slaughterhouse to discussing the childhood obesity epidemic with the Prince of Sweden to attending Senate budget hearings with Secretary Tom Vilsack.
One of the highlights of the year was representing USDA with the US delegation to the United Nations for the Commission on the Status of Women. While I was able to make some lasting changes to support breastfeeding for USDA employees, what I really learned was how ”political sausage” is made, gaining a better appreciation for the behind the scenes work that goes on by hundreds of federal employees to make this country run.
The education program consists of roundtable discussions with renowned leaders from the private and public sectors, and trips to study U.S. policy in action both domestically and internationally. Our sessions usually took place over lunch where our group of fifteen had the opportunity to discuss with leaders such as President Obama, General Colin Powel, Surgeon General Regina Benjamin, and Dr. Paul Farmer. We met with over 100 individuals who shared their views on a variety of topics from leadership lessons to their childhood to the challenge of balancing work and family. We travelled to Chicago, Detroit, New York City, and Brazil meeting with a variety of government, business, and philanthropic leaders to learn about the impact of US Federal policy on their government or organization.
The education and service programs also provided the opportunity for us to bond as a class. We met two to three times a week for various speakers, service projects, or other events. It is the bond of friendship amongst the fellows that makes this program so unique and special. Our group was diverse with physicians, a psychologist, military personnel, lawyers, an educator, social entrepreneurs and business leaders. This fellowship afforded us the rare opportunity to share in depth views with persons outside of our chosen profession. We supported each other through births and deaths and will have a life long bond.
There is not enough space here to recount all of the fantastic details of the experience. Sometimes it felt mundane (are we really meeting about having a meeting?), sometimes unfathomable (am I really walking with the President to the Oval office?). All in all it was a learning experience. I learned that to make change in Washington sometimes you have to be on the inside, and sometimes you have to push from the outside, but the real key is knowing when and how to do both. I learned that my voice is just as important as those who may be dominating the conversation. I learned that Family Medicine needs to have more of a place at the table in Washington. I learned that great leaders are just regular people like you and me with the commitment and the drive to make their vision a reality.
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Dr. Davis is the Director of Community Health and Outreach at Casey Health Institute a holistic center for primary care in Gaithersburg.
To learn more about the White House Fellows program visit the website: Applications for the class of 2013-2014 are available now and due in mid-January.