Swine Flu? Vermont Health Commissioner Wendy Davis Isn't Sweating It

For someone in the midst of both a public-health and fiscal emergency, Davis is surprisingly calm — a quality she might have inherited from her doctor dad, who was the inspiration for the Hawkeye character on “M*A*S*H.”
Howard Dean isn’t the only physician to pursue a second career as a public administrator in Vermont. State Health Commissioner Wendy Davis [1] is following the blazes Dean put in place — but only up to a point. She says that while she admired Dean’s success as governor in making health coverage available to all of Vermont’s children, she has no interest herself in seeking elected office.

Davis, 55, does have the charisma and many of the credentials needed to run a 570-person department at a time of great stress. She’s leading the state’s response to the swine flu outbreak while simultaneously maneuvering in Montpelier to minimize cutbacks to her department. For someone in the midst of both a public-health and fiscal emergency, she’s surprisingly calm — a quality she might have inherited from her doctor dad, who was the inspiration for the Hawkeye character on “M*A*S*H.”

In an interview last week in her corner office at Burlington’s Cherry and St. Paul streets, Davis said that when she took the top health department job almost a year ago, she wasn’t anticipating “the intensity of the economic challenge we’d be facing.” And although she does have experience with an earlier threat of a swine-flu pandemic, she could not have foreseen the onset of the H1N1 virus. It has so far killed three Americans and infected at least one Vermonter. While the contagion appears to be in abeyance in Vermont at present, “I won’t be surprised if we have more confirmed cases here,” Davis says.

The combination of a deadly new bug and the erosion of resources for her department will test the public-health and managerial chops of the state’s No. 1 health officer. Davis directed the department’s maternal and child-health division for a little more than one year, but this is her first go at overseeing a comparatively large-scale bureaucracy. She says she’s sure, however, that her earlier work as head of a practice group at University Pediatrics [2] has equipped her with the requisite administrative skills.

Roberta Coffin, one of Davis’ predecessors as health commissioner, expresses confidence in her fellow pediatrician. “I know she’ll rise to the challenges,” says Coffin, who has watched Davis develop for many years. Coffin was Vermont health commissioner in the 1970s when Davis, then a recent graduate of the University of Virginia [3], worked for a short stint in the health department’s original swine-flu program.

Dr. Deb Richter, leader of a Vermont campaign in support of a single-payer health insurance system [4], agrees that Davis is handling the health department as effectively as can be expected. “They’re doing a great job with a small budget,” Richter says. “They’re constantly being given added work without any added staff. I’m proud to be in Vermont because of how well the health department operates.”

Slender and quick to smile, Davis has a self-effacing manner that doesn’t entirely cloak her self-assurance. She says she brings to the health department the same determination that marked her 25 years of doctoring — mostly at University Pediatrics and later at Timberlane Pediatrics [5]. “I’m driven in my job,” she declares. “I start by deciding what’s the right thing to do for a patient and a family. You’ll then run into barriers that may be difficult to surmount, but you always do your best to overcome them.”

Davis identifies Coffin as a mentor, but it’s clear that her father, retired trauma surgeon John Davis, has been the most influential figure in her life. And he proved inspiring not only to his middle daughter but to the creators of “M*A*S*H.”

“Hawkeye” may actually have been a fictional amalgam of many field surgeons who labored under sometimes surreal and always difficult circumstances during the Korean War in the early 1950s. But as she watched the TV series “M*A*S*H” (a takeoff on the movie of the same name) on CBS in the ’70s and ’80s, the commissioner recalls, “I’d see certain aspects of that character and say ‘that’s John Davis.’”

He moved his wife and three daughters from Cleveland to Burlington in 1969 to take up the chairmanship of the surgery department at the University of Vermont’s College of Medicine [6]. Wendy accompanied her father to the hospital on Sunday mornings and waited and watched at the nurses’ station while he went about his duties, she remembers. “He was very influential in my decision to become a physician,” Davis says.

After being stricken with a disease in 1986 that left him a paraplegic, John Davis also helped cultivate in his doctor daughter “a deeper appreciation of what life is like for people with chronic illnesses and disabilities,” she notes. Davis credits her mother, now 84, with “holding the family together” while acting as the primary caregiver to her father.

She says she chose to become a pediatrician rather than a surgeon because “I love having that kind of connection with families.” Davis and her husband John Mahoney, a seventh-grade social studies teacher in Georgia, Vermont, do not have children, but the pediatric practice enabled her to play a role in the development of many patients from infancy to teenhood.

“One of the great aspects of doing pediatrics in Burlington, as opposed to, say, Cleveland or New York City, is that there’s continuity with many of the families you see,” Davis points out.

“She’s a real old-fashioned doctor,” says Cheryl Hanna, a Vermont Law School [7]faculty member who entrusted her two young children to Davis’ care at Timberlane. “She has a holistic way of dealing with a family. She has a broad view of health. She understands that it’s not only about the physical.”

In her medical profession, Davis says, “It’s all about starting with prevention.” She’s now applying that perspective to her role as point woman for Gov. James Douglas’ “Blueprint for Health” [8] initiative.

Davis smiles coyly when it’s suggested she doesn’t come across as a typical Republican. But she’s quick to aver that the Republican governor exhibits “the visionary leadership” needed to bring about major improvements in Vermont’s health-care system.

Douglas’ program encourages individuals to take responsibility for their own well-being. His health blueprint emphasizes preventive measures such as exercise, nutrition and avoidance of tobacco consumption and heavy drinking. That approach squares with Davis’ own. “We all have a role in taking responsibility for both personal health and community health,” she says. “Health care isn’t only about hospitals and doctors.”

At the same time, Davis suggests that health care in America, including Vermont, requires “a system-wide overhaul.” And a successful transformation won’t be achieved, she remarks, unless there’s “financial and payment reform.”

Davis wouldn’t say whether she sees the single-payer model as the best alternative to the health system as currently constituted. She did suggest that private insurers MVP and Blue Cross/Blue Shield have been “good partners” in Vermont’s efforts to address issues that fall under the heading of health equity.

Davis says it’s simply a fact that lower-income Vermonters are “less likely to have access to health care and are more likely to experience chronic disease related to being overweight and tobacco use.” One of her main goals as commissioner, she adds, is to help make health care in Vermont more equitable.

The state does have the expertise needed to reach that goal, she says. “It’s truly exciting to be working with a legislature and an administration with a deep understanding of health reform. I don’t think you find that in every state.”

The health-care model that Vermont is building “could be scalable to the rest of the country,” Davis suggests. She says the encouraging progress occurring here is being monitored in Washington, and represents a key reason why the Obama administration recently chose to hold one of its health-care summits in Vermont.

Davis says she decided, reluctantly, to give up her pediatric practice for the opportunity to have a broad impact on public-health policy in the state — and, indirectly, in the country as a whole. “I do miss my practice,” she acknowledges. “I can definitely see myself doing it again one day. I don’t see myself moving into politics as an elected official, but I do see continuing to work in public health. It’s just so important.”