Completing a combined MD/MPH program shaped how I approached medicine at both the patient and population levels. I loved emergency medicine, but I also saw the emergency department as a critical safety net and a window into health issues that could have been prevented. After residency training, I accepted an academic emergency medicine position with a dual appointment in public health. Now reflecting on my career to date, I realize I did not plan for the nonclinical roles I took, but rather viewed each journey as an extension of my clinical practice.
Moving Upstream Through Research
I loved caring for patients, but I kept wondering how we could prevent the next person from becoming a patient. In medical school, I participated in research screening emergency department patients for intimate partner violence. Some could not envision a life without violence because they had grown up experiencing it. A subsequent study I led found that it also impacted some of my medical school classmates. Those conversations inspired me to focus on prevention, not only treatment.
Research allowed me to identify risk and protective factors, understand patterns, and test prevention strategies. My NIH K23 and CDC R49 grants were funded during my first year as faculty, but I soon learned the hard way that most proposals require multiple attempts and one of my strongest was never funded. Building a research program required persistence, diversified funding, and perspectives beyond my own specialty. I partnered with infectious disease specialists, psychiatrists, and trauma surgeons on projects ranging from HIV screening to interventions addressing trauma and violence.
I eventually began thinking beyond individual studies and helped build the Emory Center for Injury Control as a “center without walls,” connecting 12 universities and fields ranging from medicine and public health to law and engineering. This reinforced for me the importance of a shared vision, the right people at the table, and an environment where good ideas and people can grow.
For physicians interested in research, the first step may begin by taking a recurring clinical observation into a question and finding collaborators with the needed expertise to help answer it together.
Teaching Beyond the Bedside
I also found purpose in helping others develop the knowledge and skills to improve health and health systems. I taught at the bedside, in formal courses at the school of public health, and in an undergraduate comparative health systems college class in London. I turned a violence course into a university-wide offering for students across disciplines, then helped develop it into a Coursera course that has reached more than 38,000 learners.
Teaching offered a different kind of scale: from helping one learner at the bedside to reaching students around the globe. Each setting required a different approach, from “see one, do one, teach one” in the ER to a semester-long curriculum to short online videos. Teaching also made me a better communicator. I had to make complex concepts understandable, meet learners where they were, and develop new lessons to match current events or new science.
Physicians teach every day, often without realizing it. Bedside instruction, mentoring, writing, curriculum development, and public communication can all become pathways beyond clinical care and strengthen almost any nonclinical role.
Learning to Lead Across an Institution
My path into administrative leadership was not mapped out beforehand either. I held leadership roles in emergency medicine and the Emory Center for Injury Control, but university service stretched me further and showed me how a large institution works. As chair of the Faculty Council and president of the University Senate, I met with people across schools and professions. I learned to listen and weigh competing priorities, build consensus when possible across very different disciplines, and move forward as a university team, sometimes without a perfect solution.
Leading Emory’s academic leadership program, working in the provost’s office, and completing the Executive Leadership in Academic Medicine fellowship broadened my skills in strategy, governance, budgeting, and negotiation. I also began working with an executive coach, who helped me better understand my strengths and growth areas through assessments and monthly sessions.
Committee work, special projects, leadership programs, colleagues, and coaches can reveal how organizations function and build skills for the next opportunity. Throughout my career, I sought roles that stretched me as a leader. For physicians interested in administrative leadership, seek assignments that expose you to budgets, strategy, personnel decisions, and institutional governance and choose roles that require you to work across disciplines. Leadership programs, mentors, and colleagues can then help you identify gaps and build the skills needed for the next opportunity.
Taking Those Lessons to Government and Other Sectors
When the opportunity arose to lead CDC’s National Center for Injury Prevention and Control, I saw a chance to address injury, overdose, suicide, and violence on a national scale. I also understood the tradeoff: I would step back from my own research, teaching, and eventually clinical care. After more than a decade in academic medicine, I was ready to lead in a different way and at a larger scale.
At CDC, the population became my patient. We used research to shape national programs, strengthen data so health trends could be detected sooner, and help communities put effective prevention strategies into practice. My responsibilities later expanded across the agency, including helping to lead CDC Moving Forward, an agency-wide reorganization shaped by lessons from COVID-19. And later as the agency’s chief medical officer, I drew on my clinical background to consider how guidance would work in practice and how physicians might respond to health advisories about foodborne outbreaks, viral hemorrhagic fever, or a new drug overdose.
Whether responding to an outbreak, briefing Congress, or speaking with the public, I relied on skills developed as a physician. I explained a public health threat much as I would explain a diagnosis and treatment plan to a patient: clearly, directly, and with an understanding of what needed to happen next. Briefing Congress was similar to consulting with a specialist: here is what you need to know, why it matters, where you can help, and how we can address it together. The scale had changed, but the responsibility had not: listen, diagnose the problem, and act with the best available information.
Today, I advise health departments, nonprofits, and health and technology companies, helping leaders evaluate science and data, navigate uncertainty, and translate promising ideas into approaches that work at scale. Physicians can contribute far beyond traditional clinical roles because we know how to ask the right questions, make decisions with incomplete information, communicate risk, and keep people at the center of all we do.
Lessons From a Career Beyond the Bedside
For physicians considering a nonclinical career, start with a problem you want to solve, and don’t focus on a title. Test new interests alongside clinical work when possible; a project, class, committee, or part-time role can reveal what energizes you and where you still need to develop further. Treat writing, teaching, and service as leadership development. Talk to others who are in roles you aspire to be in and find out what skills they think are important to have and what they wish they had known beforehand.
Moving beyond the bedside does not require abandoning your identity as a physician. My career has taken me from the emergency department to the classroom, the University Senate, my own LLC, and a national public health agency. Yet the question always driving my work remains consistent: What can we do so fewer people have an illness or injury that could have been prevented? Even when there is no patient in front of me, clinical experience continues to ground my work. The setting and scale may have changed, but I will always strive to prevent the next case.
