Dr. Patel Goes to Washington

washington61212One of the first jobs Kavita Patel, MD contemplated out of her OHSU Internal Medicine residency in 2002 was a concierge physician position for corporate executives.

Her patient panel would have been 250 people as opposed to 2,500 or more in a regular practice, and the executives would have had 24/7 access. She decided it wasn't the job for her, yet Dr. Patel didn't take a traditional clinical job either. Instead, she forged a third path in health care policymaking that took her all the way to the White House.

Under President Obama's senior adviser Valerie Jarrett, Dr. Patel served as Director of Policy for the Office of Public Engagement and Intergovernmental Affairs, playing a key role in helping the Obama Administration shape the 2009 federal health care reform legislation. She reviewed draft bills, wrote memos and presented key topics to the president and his senior team, and served as the outreach arm to physicians, nurses and other health care professionals. Along the way, she developed a tough skin, a knowledgeable yet respectful style and a Blackberry addiction.

Today, she is a fellow at the Brookings Institution, pursuing think tank work on health care policy. "It was a great opportunity," she said, looking back on her White House days. "But it was crazy, one of the most stressful environments I've ever been in." And she's honest about the legislative results: not perfect.

Dr. PatelDr. Patel, born and raised in Texas, earned her medical degree from the University of Texas Health Science Center at San Antonio in 1999. Between her third and fourth year, she spent a year as national president of the American Medical Student Association in Washington, D.C., her first time outside Texas and her first taste of leadership and policymaking. It got her thinking.

She chose internal medicine, a specialty she selected for its variety and flexibility, and her training at OHSU made a lasting impact. "What those years at OHSU taught me was how a team approach to care made a big difference in patient outcomes," Dr. Patel said. "At the same time, I saw a lot of uninsured people who couldn't get access to doctors or get their prescriptions." She also saw the struggles of primary care physicians, and they stirred the fighter in her.

After completing her residency where she served as chief resident, she took a nonclinical fellowship at UCLA sponsored by the Robert Wood Johnson Foundation where she studied mental health care disparities in local African American populations.Afterward, she became a research scientist at the RAND Corporation.

A chance meeting with the late Sen. Edward Kennedy's chief of staff brought her back to Washington, D.C., where she became a staff director helping Sen. Kennedy on his federal health care reform legislation. She then found herself with a job working on health care and a number of other issues in the White House.

Dr. Patel, comfortable now as a nontraditional physician, still sees patients. But her passion is policy. Her most recent Brookings paper analyzed Obama's deficit reduction plan for its health care implications. "Allow health care professionals some flexibility within Medicare and Medicaid to demonstrate their ability to bend the cost curve through innovation in payments," she argued. "By building on what was included in the Affordable Care Act around pay for performance, the Administration should consider allowing health care professionals to come forward (much like they are encouraging ideas from Governors) with payment models that will incentivize every clinician's innate desire to be their best."

"That sounds just like Kavita," said Donald Girard, MD, Professor of Medicine and Associate Dean for Graduate and Continuing Medical Education, and a mentor of Dr. Patel. "She will not accept anything but the best." Whether in government, clinic or the halls of public opinion, Dr. Patel can't help but fight on for a better health care system.

Pictured above: Kavita Patel, MD is a community physician at Johns Hopkins, a fellow at the Brookings Institution and has worked for the White House.