Although many physicians may dread the bureaucracy, political maneuvering, and protocols involved in government work, it is incredibly important that physicians have a say in the legislation that affects the health of the citizens of the United States, whether nationally or on a local scale. The vast majority of legislators have no experience working in healthcare, and need an expert to provide counsel on the unique challenges faced by providers and patients.
Beyond direct legislative advocacy and policy advising, physicians can also hold important positions in government health agencies such as the FDA, CDC, and NIH. These agencies all employ physicians to work in a number of capacities including research, safety and regulation, epidemiology, and health policy development. There is often a large overlap between roles carried out by those working in government agencies, public health, and public policy.
Enacting legislation such as ignition interlock devices for previously convicted drunk drivers, nutritional labeling on menus, smoke free public areas, or removal of a drug with harmful side effects from the market are all examples of these government bodies in action. Physicians can serve in a number of positions in the government. These include high profile director positions, clinical roles, committees, advisory positions in the various departments, or promoting government programs.
|Center for Drug Evaluation and Research||Legislative Policy Advisor|
Director, Division of Medicine and Dentistry
▪ Develop and refine medical policy and monitor compliance
▪ Review clinical trial results of new drugs submitted for approval
▪ Use medical and legal knowledge to influence public health legislation
▪ Research benefits and potential drawbacks for pieces of legislation related to public health
▪ Oversee the nation’s federally qualified health centers (FQHCs)
▪ Work on strategy and clinical quality improvement
|Example Employers||▪ FDA|
▪ Individual politicians
▪ Advocacy organizations
|▪ Health Resources and Services Administration|
Job responsibilities will vary depending on the government agency or sector of public policy.
The major subdivisions can be divided into:
- Clinical care, provided through entities such as the NIH or the Indian Health Service), research, conducted at places like the NIH, CDC, or AHRQ
- Public policy, conducted through various government bureaus, programs, and committees including the National Pharmacy and Therapeutics Committee, or Maternal and Child Health Bureau
Some positions can encompass various areas including public health, global health, and government work.
Various job responsibilities may include:
- Suggest policy changes to improve organizational effectiveness
- Research benefits and potential drawbacks for pieces of legislation related to public health
- Use medical and legal knowledge to influence public health legislation.
- Evaluate safety and efficacy of new drugs
- Participate in committees or enact legislation to improve the health of vulnerable populations
- Perform clinical or laboratory research at large government-funded medical research centers such as the CDC and NIH
- Work as a medical officers or director of programs such as the Indian Health Service
- Oversee the services provided at federally-funded health centers to patient receiving federally-funded care
- Develop strategies for advancing the nation’s health care and for clinical quality improvement
- Serve in a public relations capacity educating the public on government programs, medicine, health, and safety
- Train other public health professions
Work Environment and Schedule
Generally, work for government agencies will include relatively regular work hours, likely between 8 and 5. Depending on the position, during legislative periods, work hours may be long, requiring more research or social engagement to advocate for certain public health positions. Other types of positions may require longer hours when deadlines are approaching or there are disasters or disease outbreaks. However, hours for physician positions within governmental organizations tend to be lighter than those for traditional physician jobs, with a generous holiday schedule and the occasional government shutdown.
While some positions may be local and allow for working throughout the US, some positions may require physical location at certain headquarters or local centers. Travel may be involved with some positions, as well as media and PR involvement for the more highly visible leadership roles in government.
Required Skills and Training
It is generally expected that those working in this field have either a strong knowledge of public health or law, or a degree in one of these areas. Those with expertise in both medicine and law may be particularly sought after.
Required skills include:
- Ability to navigate local, state, or national public policy
- Strict adherence to government protocols
- A degree in public health, law, or other training may be desirable for some roles, but not necessarily required
Residency, Licensure, and Training Requirements
Board certification and licensure is required for some positions, as well as clinical experience. Other positions are suitable for a physician with incomplete post-graduate training or without much experience following residency. Many governmental positions include on-the-job training components and continuing education.
Is This a Career for You?
For those who are interested in legislative advocacy, impacting public health through legal means, or forging a relationship between the medical community and the government, a position in a government agency or in public policy may be enjoyable. Physicians who are determined, gregarious, convincing in an argument, and logical will likely do well in positions in government.
These positions would not be well suited to a physician that does not like regulation, protocols, or hierarchical organizations. Physicians who prefer to avoid the spotlight or like a greater degree of autonomy may find a leadership position in government or public policy challenging. Ultimately, there is a great degree of overlap between government roles, public health and advocacy, and some global health positions, so a physician with interests in many areas may be able to find a fitting role.