My Kind of Medicine: Real Lives of Practicing Internists: Kavita Patel, MD
On the steamy Wednesday afternoon of July 9, 2008, members of the Senate waited anxiously in the Senate chamber as the votes were cast. Hanging intangibly yet precariously in the air was H.R. 6331—“the Medicare bill”—vetoed by President Bush and in danger of slashing Medicare payments to doctors by 10.6 percent. Then the door opened and through it, escorted by Senator and presumptive Democratic presidential nominee Barack Obama, Senator John Kerry, and Representative Patrick Kennedy, came the man of the hour, Senator Edward Kennedy of Massachusetts. Applause rang out and the tense atmosphere dissipated as Republicans and Democrats alike greeted Kennedy’s first return to the chamber since becoming ill in May. “I return to the Senate today to keep a promise to our senior citizens,” Kennedy said in a statement, “to protect Medicare. Win, lose or draw, I wasn’t going to take the chance that my vote could make the difference.” It was an engaging scene befitting of a movie, but the work that went into it was anything but—hours upon hours of researching, drafting, editing and deliberating. As Deputy Director of Kennedy’s Health Subcommittee, it is the kind of thing that Dr. Kavita Patel, 34, does on a daily basis. She is not complaining, though. “I love that I get to think about an issue that’s important and put together something that might be meaningful that will actually have an effect on how medicine is practiced,” she says enthusiastically. “I consider it a privilege.”
Going to Bat
Dr. Patel’s job is to advocate on issues important to Senator Kennedy, which she says generally fall into one of two categories: quality of care and chronic disease. She does this any number of ways, for example, drafting legislation or looking into proposed regulations on a health training program. All of it involves a lot of talking to people, which bodes well for Dr. Patel, who is quick, easygoing and pleasant to talk to all at once. She makes a partner in conversation feel at ease and comfortable, undoubtedly a desirable and necessary skill for a job working in the office of one of the nation’s most prominent legislators. A typical day for her begins early with emails, followed by meetings and phone calls, which take up the majority of her time. Around 5 or 6 p.m., she gets to work on legislation, something she enjoys very much, as it is one of the more tangible parts of her role. “The best thing so far I would say has been working on a cancer bill for Senator Kennedy,” she says energetically. “It’s probably one of my proudest moments, putting together the hearing that Senator Kennedy chaired on it,” she says. “It’s amazing how a tweak here or there can make a difference.”
For the Medicare bill (H.R. 6331), Dr. Patel’s efforts focused on protecting low income beneficiaries as well as addressing the concerns of constituents from the Commonwealth of Massachusetts. “I worked on some of the issues related to quality and I talked with our staff director about whether we were supportive of the changes,” she says. “And I worked a great deal with a number of other Senate offices making sure that low income beneficiaries remained protected.” She worked in conjunction with other staff members, who like Dr. Patel, were chosen for their respective areas of expertise. “We all come from different backgrounds—neuroscience, public health, research—and we translate it into a desire for action, to push things forward.” She says this passion is a common thread among Hill staffers, and adds that working with other Senate offices is not as partisan as people might suspect. “Some of the best conversations we have are with our colleagues on the other side,” she explains. “It doesn’t matter who you work for, we all more or less want to put people’s needs first.”
The commitment shown by Dr. Patel and others is reciprocated by Kennedy. “It’s not uncommon for him to ask me a question and then repeat my answer later on during a meeting or conversation,” she says. “He really believes in us and will go to bat for us if he needs to.” Despite the pressures, she considers her role incredibly rewarding. “All of the times that I’ve had the opportunity to actually be around Kennedy, watching him do what he does are some of the more rewarding moments I’ve had in my career,” she says. “He’s really just magical, the way he talks to other members or listens to a constituent. People love to be around it.”
In the Club
From the time she was a little girl, Dr. Patel was enthralled with the idea of being a doctor. To her, the world of medicine represented a mysterious and exclusive club or society to which only precious few could gain access. “No one in my family had gone into medicine and I was fascinated by this area of science that to me was held in secrecy,” she says. “It seemed really important, and I wanted to be a part of it.”
She graduated from medical school at the University of Texas Medical School at San Antonio and followed with a residency at Oregon’s Health and Science University Program. Following residency, a job as a research fellow at UCLA laid the foundation for her to hone her talent for examination and investigation; it was not long before she landed a job with RAND, the high profile non-profit organization once considered a global policy “think tank” in its early years when it serviced the U.S. military. Since expanding to work with other governments, private foundations, international organizations, and commercial organizations, RAND has built a reputation for rigorous, quantitative, and non-partisan analysis and policy recommendations. Her duties there included participating in several health service research projects, including a community based participatory research project in south Los Angeles looking at novel ways to expand access to mental health services.
While at RAND, an acquaintance of hers who also knew Senator Kennedy approached her about a staff position. Even though it would mean relocating across the country, she decided to try for it. Getting into that club, however, would prove to be a bit more challenging. “I interviewed with five different people before I got to him,” she recalls. She was intimidated at first, she says, since Kennedy can seem larger than life, but was soon at ease once she sat down with him. “I was impressed with how giving he was,” she recalls. “He was really interested in what I was excited about. He’s a gracious employer and he has a sense of respect for medicine in general.”
Since being hired a little over a year ago, Dr. Patel has enjoyed the ride and says she plans on staying put. “I came on board knowing that if and when there is health care reform, Senator Kennedy is going to be a major player,” she explains. “That’s what I signed up for and moved across the country for.” She says trading California for Washington has been a good trade, aside from “the horrible weather.” And surprisingly, she says working in Washington has provided her with more structure than her previous career in research. “I can actually relax … read a book or do some yoga,” she says, “I like it, it’s a balanced life.”
Dr. Patel credits her experience as a practicing physician, and in part, her internal medicine training, as the basic building block of her career. “My perspective as a practicing physician has allowed me to do all of this,” she says. She adds that she would encourage students to pursue internal medicine, but with a caveat. “If you are going to pursue a career in internal medicine, think through what kind of practice setting would best suit your strengths and lifestyle balance, and then pursue that aggressively.” Her recommended approach sounds much like her own, which might not be bad advice to follow. Afterall, it worked pretty well for her.
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