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Alumni Advice: Michael Banyas on the Rewards of a Career in Public Health

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Michael Banyas ’03 is currently a lieutenant commander (LCDR) in the U.S. Public Health Service (USPHS), one of the nation’s seven uniformed services, and a public health analyst in the Bureau of Primary Health Care within the Health Resources and Services Administration, U.S. Department of Health and Human Services.

AlumniAdvice_newWe recently spoke to the Washington, D.C., resident about his career in public health and government and how the lessons learned from his work in public health shaped his professional development.

Can you describe the work you’re doing now in the field of health care policy and management?

My current position involves providing policy guidance and overseeing the use of federal grants to Federally Qualified Health Centers (FQHCs) in New England, including Vermont, and in Western states (Oregon and Utah). FQHCs are community-based organizations that provide primary and preventive care such as health, dental, and behavioral health/substance abuse services to medically underserved and vulnerable populations, including the uninsured and those living in poverty. They are located in urban, rural, and frontier areas across the United States. Vermont has 15 FQHCs.

My program oversight and policy work assists these community health care providers in providing access to high-quality health care to underserved patients and confronting their community’s public health needs while ensuring the appropriate use of U.S. taxpayer money. Understanding public health and its social determinants at a local level in such locations as schools, neighborhoods, communities, and workplaces is critical for curbing chronic diseases like diabetes and confronting sudden public health outbreaks like the opiate epidemic spreading through much of New England. Health centers also have a key responsibility in implementing health care reform through the Affordable Care Act. As someone who has worked on health care policy in Congress and the federal government, I am able to see how those policy decisions are implemented and affect health care closer to the ground. Understanding how policy works once it “hits the road” is invaluable for one’s development as a policy maker and program manager.

Tell us more about your background.

I graduated from UVM in 2003 with a Bachelor of Arts degree in political science and English. I then attained a Master of Public Administration from New York University’s Robert F. Wagner Graduate School of Public Service in health policy and administration and undertook additional graduate work at Columbia University and the U.S. Naval War College. I grew up in Orange, Connecticut, and originally enrolled in UVM as a Guaranteed Admission Program (GAP) student.

Prior to my commissioning as an officer, I worked in a variety of health care management and policy settings, including in the offices of senators Edward M. Kennedy and Christopher Dodd, the University of Vermont Medical Center, the National Institutes of Health, the Centers for Medicare & Medicaid Services, and New York University’s School of Medicine.

While a student at UVM, you worked as an intern at the Division of Correctional Health Services for New York City’s Health and Hospitals. How did that experience shape your perception of public health?

I grew up in a suburban town in Connecticut located between New York City and New Haven. Prior to this position, my experiences in New York City were limited to seeing events at Madison Square Garden and Yankee Stadium and exploring safer Manhattan neighborhoods, such as around NYU. Additionally, my only exposure to the corrections system at that point were the stereotypes I experienced from television and literature.

While I was excited for my internship in New York City and to be working in an agency of one of the largest public health care systems in the world, I quickly understood the complex public health and poverty issues many people do not see in all five boroughs of the city. For example, the agency I worked for oversaw prison health care services for jailhouses in all five New York City boroughs and Rikers Island. Not many people realize that every time someone is arrested and brought to the borough corrections house, they receive a full health care exam within 24 hours, which includes testing for communicable diseases, such as hepatitis, tuberculosis, and HIV. While the guards refer to these people as inmates, once they walk into the clinic, they are referred to as patients. This was strange at first, but important for establishing trust with the person and formulating the patient–health care provider relationship.

Initially, I could not understand why the city was aggressively supplying these services to inmates, even if they were not being sent away to Rikers Island for the long term. However, I quickly understood the public health importance of this care. Many of these individuals come from areas in New York City with high levels of poverty and have never seen a doctor or dentist. It opened my eyes as to why public health is important in a long- and short-term context. For example, getting care to corrections patients living with tuberculosis before they reenter their community or the corrections population is critical for curbing the further spread of that communicable disease within these populations. It was the first time I saw how poverty affects health and the importance of health care access. Lastly, it also led me to an understanding of how important teamwork is in solving complicated problems. I saw how health care is a team sport and the provider can only do his or her job if supported by managers, technicians, and other providers to ensure patients, especially as medically complex as this population, receive the care they need.

As a public health analyst, what is the toughest part of your job?

Working within an ever-changing, large bureaucratic organization is the most challenging part of this job and any job I have ever had, whether government or nonprofit. The work with FQHCs is interesting and challenging, and I like how this assignment enables me to apply my past leadership and professional competencies to my current work. However, the growth of my current agency’s mission, as a result of the Affordable Care Act, brings new challenges. These include reorganizations and shifting internal relationships in order to adapt to the work, which occurs at breakneck speed. It is important to explain to stakeholders at the local level the current state of the organization, since this can impact their ability to do their jobs and may complicate their work in the short term.

The best advice I can pass down to young and midlevel professionals in this type of environment is the following: Be patient; keep your head down but pounce on opportunities when they arise; and learn from leaders around you how they handle these situations so that you can apply these lessons learned when you are in their position.

What are some of the greatest rewards?

Currently, it is rewarding working with health care providers delivering care throughout communities in New England where I grew up, went to school, and still vacation. Often times, one of my stakeholders will mention a street in New Haven or a town in Rhode Island with which I’m familiar. I believe I am utilizing the leadership and professional skills I developed in the past to work with health care professionals to improve the communities I have an intimate connection with in my life. It has also been eye-opening to now work with providers to help deliver care to underserved people I did not realize existed in these locations. For example, one of the two health centers I oversee in Vermont is located near my uncle’s house in Southern Vermont where I learned to ski and spent many summers. I am very familiar with this part of the state. It is also surprising to realize how many underserved people are located in this area whom I never noticed, but extremely rewarding to help local providers confront this area’s community public health problems.

What are some lessons you’ve learned in your career?

Here are a few:

  • Don’t assume answers or be afraid to ask questions. Precise information is important for preparation and preventing errors for producing quality work.
  • Know how to write. One of my UVM professors said that if you cannot put your ideas and thoughts clearly on paper, your ideas are worthless.
  • Character is invaluable. All too often people focus on their résumé rather than character virtues, such as integrity, honesty, and humility. Sometimes it does not matter if you are not the smartest and most well-qualified person, but if you are the person who is team oriented, has leadership qualities, and has values that reflect the organization’s mission, you will stand out.
  • Know how to recover from your mistakes and failures. Everyone fails, but it is important and a true test of character how you learn from those disappointments and pick yourself up and dust yourself off. It also builds resiliency, important for succeeding not just in your career but in life.
  • Personal relationships matter. Cultivating relationships—in person and not just online—is critical for building emotional intelligence, cultivating teamwork skills, recovering from mistakes, creating opportunities, and growing as a professional.

What are some public health issues in the U.S. that you believe need the most attention?

First, I would say health literacy in terms of how effectively we translate complex information to patients so that they can change behaviors that affect their health. Second is the challenge of improving access to care, such as alleviating health insurance coverage issues, and many areas in this country have health provider shortage problems, including areas in health-care-dense professional environments, such as New York and Boston. The third issue is substance abuse, including the opiate problem, which is huge, but also alcohol. Substance abuse affects the rich, the poor—everyone.

Are there some experiences from your work that have given you a greater understanding of public health?

When I graduated from NYU, I had the amazing opportunity to participate in a two-year postgraduate fellowship in the U.S. Department of Health and Human Services. In this experience, I was able to work on a variety of policy and management issues. But most importantly, I was able to work with many leaders who helped set me on the career path I am on today. These experiences included learning how scientists and doctors at the National Institutes of Health translate research into practice for patient care and find cures for diseases; learning how Medicare works to pay providers to ensure high-quality health care for its beneficiaries; and working with USPHS officers in formulating national disaster preparedness plans after Hurricane Katrina. While the work itself was fascinating, what gave me a greater understanding of public health were the leadership traits I learned were necessary to approach problem solving. Many of these public health problems are difficult; it was through mentorship and leadership guidance that I began to grasp the variety and complexity of public health problems facing our nation and its communities as well as the world.

What advice would you give someone thinking about working in health care policy?

In your coursework, try to take as many social science classes as possible—anthropology, sociology, economics. In addition, statistics is important—because everything is now data-driven. These areas will help you understand how policy is translated into the community and how people make decisions driven by incentives. Also, if you are in Vermont, take advantage of the many resources there—health care centers, hospitals, nonprofits. I was fortunate to work for the General Counsel of UVM Fletcher Allen Hospital when I was in school and received an invaluable and unique professional experience by knocking on doors and leveraging my relationships. Don’t think you have to be totally qualified for an opportunity, but take the initiative to put yourself in a position where you have a chance to succeed or show that you belong. Don’t be afraid of failure, and if you don’t succeed, don’t give up—try again.

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