My Kind of Medicine: Real Lives of Practicing Internists: Georges Benjamin, MD, FACP
From the vantage point of his eighth grade science classroom in Chicago, it was difficult for Georges Benjamin to see the future ahead of him, but the frog—primed for dissection on the table in front of him—was a clue. Although he did not realize it at the time, mastering the art of frog dissection would instill in him a focus and discipline that he would need for the many roles he would later play: as a Major in the Army, as the chief of an emergency medicine service, as a medical administrator, as a Deputy State Secretary for public health services, as a State Health Secretary, and as the Executive Director of the American Public Health Association (APHA). But for all his calculation and skill, none of these achievements could have been possible if it were not for his great passion. “I literally fell in love with internal medicine as a fundamental discipline,” he says.
Falling in Love
Dr. Benjamin’s career can be traced back to two major decisions. The first decision he made while in college at the Illinois Institute of Technology, when a friend suggested he pursue medical school. As an undergrad, Dr. Benjamin was engrossed in research and studied sickle cell disease, and while he found the research fascinating, he was frustrated by his lack of fundamental knowledge from a medical standpoint. “Unlike many doctors, ‘being a doctor’ was never on my radar screen when I was younger,” he explains, “but I wanted to know more—more about the basics like anatomy and physiology.” So he heeded the advice of his friend and attended the University of Illinois College of Medicine. And once he got a taste of clinical medicine and saw his first patients, things began to change. “As I learned more about clinical medicine, the research idea began to drift away,” he says. “I also fell in love with the emergency department.”
His first student rotation in internal medicine was in Chicago, where he worked in community hospitals. There, he worked under an attending physician who helped him understand what the field was all about. “He was extraordinary,” Dr. Benjamin recalls. “From him I began to understand the detail needed to provide comprehensive care and the focus needed to address patients’ most serious problems. Internal medicine is really the core of understanding the process of health. I believe that internal medicine is an honored discipline and the core of being a primary care physician.” He says that today’s medical students need to understand how studying internal medicine has the capacity to lay a foundation that can open up many doors. “If you study internal medicine, you can go on to do a number of things because you have so many skills. Students need to understand what a wonderful opportunity that presents.”
Timing is Everything
In 2002, Dr. Benjamin’s tenure as State Health Secretary for Maryland was coming to a close. After such a successful run, which included playing a key role in developing the state’s bioterrorism plan and Medicaid managed care plan, he knew he wanted to stay in health policy, and he knew he was ready for the national level. The chances of that happening however, were rare. “Jobs like this don’t open up very often,” he says, “but in this case the timing was right. I just knew it had to be other forces coming together.”
Three months later he got the gig, where he has stayed happily for five and a half years. As Executive Director of APHA, Dr. Benjamin oversees a staff of about 75 people, a budget of $15,000,000 and a membership base of about 50,000. His role on the most basic level is to make sure the organization fulfills its overall purpose of protecting American communities from preventable, serious health threats. He does this in a number of ways: by speaking publicly, developing media advocacy, crafting APHA’s advocacy message, and attending a lot of business meetings. He takes his job to heart and is mindful of the organization’s 136-year history. “This is an honored association,” he says. “It has a historic need and at this time in history I feel our purpose is more critical than ever. What I love most about my job is that it gives me a chance to influence the health of millions of Americans in a helpful way. It really makes me want to get out of bed in the morning.”
He says the bigger rewards of the job can be slow-coming but worth it. “In these jobs, you don’t get the rush of treating critically ill patients and seeing them walk out the door healthy,” he explains, “it’s more slow and methodical. But when something comes to fruition on your watch it’s wonderful.” He cites the recently passed prevention benefit in the Medicare bill as an example. “For us here, we’re pleased as punch at how far it’s come,” he says. “From Medicare being created as a treatment-only program to now including important preventive health benefits is a major change that will support future efforts on health reform.”
Another rewarding experience for Dr. Benjamin came while he was working as State Health Secretary for Maryland when the state had successfully obtained its portion (several million dollars) of the national settlement agreement from the tobacco companies. “We were able to work with the legislature in a very productive way to strike a compromise to ensure the dollars went to health and not roads,” he recalls, “which sounds easy enough but coming to an agreed decision on how the state was going to use those resources was a very political process. There were certain points where I was sure the deal was going to die, but at the end of the day it came together.”
Army of One
The second big decision was joining the Army, where he would earn the eventual rank of Major and help construct a teaching program for nonemergency medicine residents at the Walter Reed Army Hospital in Washington, D.C., where he was chief of emergency medicine. It was intimidating, as all of the officers he worked with outranked him. “I had to develop this program as a young captain in a place full of nothing but colonels!” he remembers. “I learned a lot from them. They were smart, experienced administrators and extraordinary clinicians. For me, it was a very maturing experience. I learned about systems, about quality improvement.” The experience helped Dr. Benjamin greatly when he returned to civilian life, as well. “In essence I had to build an academic service and I was struggling for resources. My experience in the Army made me better able to handle that. The people I worked with at Walter Reed are still very much my close friends,” he says. “I consider many of them my mentors.”
“The most important lessons I have learned are in the realm of institutional and medical politics. Managing in a highly political environment is also challenging but I have learned a lot about how to create partnerships, which is an essential skill particularly in large or complex organizations.”
In all of his roles, Dr. Benjamin has learned something different. From his time working in medical administration and in the Army, he learned management. From emergency medicine, he learned how to perform in the thick of chaos. From working in state health, he learned the game of politics, and from being an internist, “I learned to be thoughtful and strategic in my thinking,” he says. And to think it all started with a frog.
Check out previous articles as physicians share what motivated them to become physicians as well as why they chose their particular type of practice.
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