Maddie Traylor spends her days helping health care professionals figure out where they’ll actually be happy at work.
So when she had me on Healthy Careers, we started with the obvious question:
How exactly does one person go from epidemiologist to five Senate offices, a convent, the White House, naturopathy, and eventually building health plans?
There was no master plan.
I started in epidemiology because I loved medicine but hated the lab. I read The Hot Zone, discovered there was a field that combined medicine with statistics and social science, and thought: That’s it.
Then I lived on Capitol Hill, went to church on Capitol Hill, and somebody eventually figured out I knew public health and was a Republican.
That was apparently rare enough to get me hired by the Senate.
I loved it.
I worked for five senators. Then I left to become a nun.
Yes, really.
I’d become Catholic while working in the Senate and wanted a radical life. Religious life was beautiful, but eventually I realized it wasn’t mine.
So I left.
The nuns were incredibly gracious. They’re still in my life. Years later, they became some of my first health plan clients. They sang me down the aisle at my wedding, Sound-of-Music style.
Then I went back to politics.
One of my old Senate colleagues joined the Trump campaign in 2016. I saw him looking disheveled, sleep deprived, and like he desperately needed help.
So I helped.
That turned into the campaign, then the transition, then the White House.
None of these moves looked particularly logical from the outside. But each one made sense when I was standing in it.
And I think that’s part of what Maddie means by finding your happy. Sometimes the safe choice isn’t actually the one that makes you smile.
She sees that every day with physicians and PAs.
Plenty of clinicians finish training and choose the employed model because it feels safe. After eight years of hell, they just want a job without pressure where they can doctor people.
Understandable.
Then they get inside and discover all the crap that comes with the “safe” job - and how many of the incentives get in the way of doctoring people.
If they took on the risk and stress of independence, two or four years from now, some of them might be way happier.
The catch is volume: independence only works if patients walk through the door. That’s where employers can change the equation.
When we tell a direct primary care doctor we’ve got 2,000 new patients for them, it can make their day. Suddenly they may have enough volume to hire the buddy who is still stuck in the system.
It works for specialists too.
We have a gastroenterologist in Kansas City who wanted to be the GI doctor for one of our employers. He gave us a great rate, and now he does the colonoscopies, office visits, and surgeries for that group.
Depending on how many employers in a community get involved, you can change specialists’ lives and help them stay independent.
It’s not easy. It’s whack-a-mole. The PBMs, pharma companies, hospital systems, and carriers keep finding ways around what we do, and we keep chasing each other around the business.
But I can sleep at night.
When I left the White House, most people with my résumé could have gone to work for industry. I couldn’t do it. Everything in health care looked apocalyptic to me except this one little community of guerrilla-style benefits advisers trying to build something different. So I glommed on and made them teach me.
It’s hard every day, but it’s worth the effort. Maybe that’s what I’ve been doing all along. Just following the thing that still lets me recognize myself when I get there.
Sometimes that led to the Senate. Once it led to a convent. Eventually it led here. Maybe this is my last pivot. Maybe there are more on the way. Time will tell. And that’s okay.
Give my conversation with Maddie a watch. It’s a fun one.