A Day in the Life of a Public Health Attorney, with Joanna Suder

Joanna 0:00
I think there’s a ton of different ways to be a health lawyer. And any way to give back and to improve the health of the population, or law through advocacy is very important.

Sujani 0:16
Welcome to PH SPOTlight, a community for you to build your public health career with. Join Us Weekly right here. And I’ll be here too, your host Sujani Siva, from PH SPOT.

Hey, Joanna, welcome to the PH SPOT podcast. And thanks so much for joining me today.

Joanna 0:37
Thanks for having me, Sujani.

Sujani 0:39
Yeah, and, you know, I before we started recording is telling you that I’ve actually come across a number of people who will be very interested in hearing about your background and kind of the journey that you took to becoming a lawyer within the space of public health. I think the journeys that I’ve heard, mostly have been individuals who have completed a public health degree of some sort, and then either work in the field for a little bit, and then go on to get their law degree. But either way, there’s that great intersection between health and law that I’m really excited to get into and then hear your unique story as well.

Joanna 1:13
Yeah, I’m excited to speak with you today.

Sujani 1:15
I guess. Yeah. Maybe we can just jump right into how you enter the field of health law. And I’m curious, which came first, so maybe you can tell us a bit about that?

Joanna 1:24
Sure. So for me, I would say I guess, law technically came first. I think I always wanted to be a lawyer, probably since the time I was a little kid. And as I grew up, I kind of changed from that a bit. I kicked around social work, I actually kicked around priesthood for a bit, actually, as well, so, so service jobs. And then after college, I knew I was going to apply for law school. But I took a few years off, I wanted to work and make a little bit of money and have some time off. And I ended up working in a health care office, a reproductive health center that we do not need to name but I think we can all guess what that is. And I had a great time, I worked there for a little over a year. And I worked with patients on a daily basis, I took vitals and histories and provided birth control education and pregnancy options and everything. And I really loved it. I love the patient care aspect. And I did consider going into nursing, but then said, I really I’m not good at chemistry. So maybe that’s not for me. So I stayed on track and apply to law school. And when I was starting to get my acceptances, one of the schools I applied to had a Health Law Program. And I said, huh, that sounds really interesting that, you know, is- is kind of the intersection of what I’ve done and what I like, and you know, maybe that is what I can do. And maybe that is what I should do. And that’s where it all started.

Sujani 3:13
Yes. You said, you’ve always kind of known you wanted to be a lawyer. What was it about the profession that you knew at such a young age that attracted you to it?

Joanna 3:23
I’ve always wanted to be in service to others. And I’ve always wanted to be an advocate as well. Of course, I had those teachers who said, you know, you’re pretty argumentative. You should be a lawyer, and every lawyer says to every person who brings it up, like that’s a terrible reason to be a lawyer, right? Like, being a lawyer isn’t just sitting around arguing all day. My kind of lawyering is definitely not that, I am not a litigator. I’m a problem solver, if anything. So I think just being that creative thinker, that creative problem solver, that advocate for my clients is what I wanted to do.

Sujani 4:03
It sounds like in terms of education, the law degree came first. But it also sounds like you were already kind of interested in this field of public health and even got some experience working at that clinic. So I would argue that maybe public health came first.

Joanna 4:20
Yeah, maybe- maybe they came around the same time.

Sujani 4:22
Yeah, exactly. Okay, so the the health law degree that you said, you discovered, how is that different? And I guess pardon my ignorance here with just how the law degrees work. But how is that different from the generic law degree that one would get?

Joanna 4:39
So it’s super interesting. We take specific coursework on health law, so we have a general health law coursework. So there’s medical malpractice, there’s healthcare finance, business regulation, I did not take public health law. It didn’t work out with my schedule. We took patients safety. And then at my school, we also did a co op placement. So I did basically an extensive internship as well in health law. So I worked for an agency that provided advocacy to low income individuals struggling with their insurers, essentially. So providing representation and fair hearings with their insurers to make sure their benefits were covered. So it really is just focus on health law within the law degree, whereas any other law degree is more general. This was more of a healthcare focus.

Sujani 5:39
And does that mean that your workload and things like that are also much more I guess, heavier than the generic law?

Joanna 5:48
Not necessarily. I think just more focus, we picked our classes, you know, we didn’t get to do as many potentially, you know, throw away classes couldn’t take a film class.

Sujani 5:59
Right.

Joanna 6:00
I was looking at spreadsheets and figuring out balance sheets and things like that. But I don’t think it was much harder.

Sujani 6:07
Yeah. Okay. That’s good to know. And then I suppose, you know, upon graduation, that path is very similar to anyone doing a generic law degree as well.

Joanna 6:17
Correct. Yeah. But the good thing is, you know, I think I came out with more marketable skills. Right? I came out knowing HIPAA, when I was in law school, that is when the Affordable Care Act was passed. So I came out knowing what was in that law, that law was over 900 pages long, right? So I reviewed it and I knew generally what was in it, which a lot of law students didn’t. So that was- that was helpful.

Sujani 6:43
And I guess, you know, once you graduated, you were a public health attorney, as I understand, is that kind of the role that you took on right away?

Joanna 6:51
Oh, if only it were that easy. So I graduated from law school in 2012, which was tough time to graduate law school, not as tough as 2009. But certainly still kind of rippling from the recession. When you graduate, you have to take the bar, and you have to pass the bar. So I took the bar, and I passed, and I did not have a job. So I was actually a volunteer attorney. And I volunteered for my state attorney general’s office in their Medicaid Fraud Control Unit, working through some of their criminal cases, just helping out however I could, and I was also working part time as well. And then I got a temporary job prosecuting individuals before their administrative boards. So nursing complaints, Real Estate Appraisers, and I was good at that, I could, I could read a medical record. And then about a year after that, is when I began representing the Division of Public Health for the state. So it took about two years from graduation to representing the Division of Public Health and becoming a public health attorney. And honestly, it is typically not even that quick, that is considered pretty entry level two years, and to get general counsel work that quickly is surprising. But because I had that education and that knowledge base, they kind of took a risk on me, because I knew HIPAA, and I knew the general background of public health, they figured out that they could teach me how to be a lawyer, because I already knew public health.

Sujani 8:35
Okay. And so is that kind of the role that you envision for yourself when you entered the program?

Joanna 8:41
Yeah. And my, my colleague always joked that I got my dream job too early. And I just kind of have to, like, sit with it for the next 20 years. So yeah, that I mean, that’s kind of what I always dreamed up. I always dreamed of representing the Public Health Department, and there’s only one person who does it in our state. So that’s, yeah.

Sujani 9:02
Congratulations.

Joanna 9:03
Thank you.

Sujani 9:05
Okay, so since there’s only one person that represents the public health division, do you consult with other lawyers while you’re kind of working on cases? Or does- does it feel more kind of like a job that you have to do on your own?

Joanna 9:20
So our Division of Public Health is within the Department of Health and Social Services, and there are 11 other divisions within.

Sujani 9:28
Okay.

Joanna 9:29
So there are seven total attorneys who represent the Department of Health and Social Services. So I work with them closely on a daily basis, and I actually manage the other six attorneys. So yeah, we work super closely every day, and it’s fantastic and the way our state is structured, I do not work within public health. I work with all attorneys. So you know, I work with the attorneys for technology or for Management and Budget, which is is really helpful because we can bounce contracting issues off each other or legislation issues, regulatory issues, litigation issues off each other. So that is super helpful. But there are issues that no one else is ever going to deal with. And those I do have to just figure out on my own, and a lot of those came up every day in the pandemic.

Sujani 10:22
Yeah, I bet. I don’t know if you could kind of share what a typical day looked like pre pandemic and then how it shifted after the pandemic.

Joanna 10:30
So the thing I love about my job is there’s no typical day, right? If you think about all the things that public health touches every day is going to be different. And public health in our state is everything from infectious disease to medical marijuana, Animal Control, vital statistics. So you have questions coming from left field, right field every day, but I handle employment, I handle litigation, contracting, legislation, everything. So some things are constant. There’s always Freedom of Information, Act requests, there’s always legislation, there’s always contracts, but a lot of times you get these niche issues, specific questions, right? There’s always HIPAA, there’s always data issues, privacy issues, but these were manageable. I’m a government worker, I like my 8:30 to 5.

Sujani 11:23
Yeah.

Joanna 11:23
I like my work life balance. And it was just a happy, manageable life, or a pandemic.

Sujani 11:30
And then, I suppose, since the pandemic, a lot of your files have been revolving around that topic of COVID-19?

Joanna 11:39
Yeah, definitely. One of the easiest ways to describe it, which I think helps a lot of people is like most of the world, right? You know, one day we’re in the office and one day we’re home. And everyone said to me, well, we didn’t really have VPN. Well, so how did you get all your files and I was like, my files didn’t help me. I created everything from scratch.

Sujani 12:02
Yeah.

Joanna 12:02
Nothing that I had ever done before would have helped me. I had a blank document that I created from scratch every day. And that is what I used. So I didn’t need VPN, right? I needed a new computer. And that’s what I had. Thank God. So yeah, it was- it was completely different. But luckily, we- we scrambled together, a team of attorneys, emergency management has an attorney. And we crafted together all of these orders. We met every day for what seemed like months. And-

Sujani 12:36
Yeah.

Joanna 12:37
We made it work. But it was a lot.

Sujani 12:39
Yeah, I bet. I’m just thinking pre pandemic, you were listing all the different areas of work that you were involved in. And kind of just like thinking about the lawyers that I have come across, you know, real estate lawyers or family law. And those individuals, at least from my perspective, are focused on this one topic. And they become I guess, experts in that one topic. Within the public health unit that you’re working in, do you feel like you need to know a lot of things because you listed employment law, and then there’s infectious disease. And then there’s the animal side of things. There’s a feel sometimes that you need to be a jack of all trades within the legal profession?

Joanna 13:21
Oh, definitely, every day. And when I train up new people, you know, a lot of it is you just need to know enough to spot something, to know that you need to know more, right? Something that came across my desk yesterday. And I was like, I know enough to know that this is suspicious. And I know enough to know where to look to find out why it’s suspicious. It’s a lot of that it’s a lot of instinct and honing that skill as well.

Sujani 13:53
Yeah. And I don’t know how much you’re able to share. But are there any specific cases that you’re able to just use as an example for anyone interested in becoming a public health attorney just to get a sense of, you know, what that actual task or the activity on hand looks like?

Joanna 14:09
So this one is public info, and this is this is not glamorous, but this is part of my job. So I represent animal welfare. And they have had an ongoing case for the last six years. It’s a tort case. So that is a civil wrong from a woman who claims that they killed her dog, and she is alleging damages in the hundreds of 1000s of dollars. And I have been back and forth with this woman in two levels of state court, about 10 different times, and she has also filed within the Supreme Court of the United States. Right? And it’s just like, every time I’m like, Oh, she’s back.

Sujani 14:53
When you say that the woman has filed a case against them. You’re referring to the public health division.

Joanna 14:59
Yes, against the state in general. Yeah. So defending that case is part of my job. There are employment actions, which, obviously are not public, but defending those as well. General contracts legislation, which is public, a lot of it is not going to be things that I can discuss because they know attorney client privilege. And typically, the work I do is not going to be in the public realm, which is-

Sujani 15:29
Yeah.

Joanna 15:29
-kind of my purpose, right? I am a preventive lawyer. If I am in court, typically, I have done something a little bit wrong. I am not someone who is going to bring affirmative litigation on behalf of public health. So yeah, I don’t know if there’s anything else I can think of.

Sujani 15:47
No, that makes sense. And I guess like there are there are these cases that are kind of quote unquote, active, but then I’m sure you also do a lot of consultations within the division where there’s a project that a team wants to work on, you would be the individual that they would contact just to kind of make sure that they’re crossing all the T’s and dotting all the i’s, I suppose?

Joanna 16:07
Yeah, of course. And I mean, I reviewed all the contact tracing scripts, when we set up COVID-19 contact tracing, just to make sure that, you know, everything that was being asked was- was legal, social media policies, right, ensuring that they conform with the First Amendment. And with existing case law. Here’s something that was public, public health had a HIPAA data breach during the pandemic, right, like the absolute last thing you ever want to deal with ever is a HIPAA breach, especially during a pandemic. So we got to deal with that one. So just small issues like that.

Sujani 16:50
I’m just thinking back to the pandemic, I’m on maternity leave now, when I was working, kind of the start of the pandemic, as an epidemiologist and my days were not the nine to five balance that I had previously. So how did that change for you? And how did you cope with that?

Joanna 17:06
Yeah, I mean, it was rough, right? I have a young child, he’s currently he’s almost five. But when the pandemic started, he was two. And when daycare shut down, for any parent, it was the hardest time imaginable. And I was working every night, every weekend. My husband is an epidemiologist, he was working every night, every weekend, I’m still working most nights, most weekends, I have not caught up from 2020. So yeah, it was incredibly difficult it is- it is still incredibly difficult. I certainly rely on my husband, a ton. He is in academia, so his schedule is a bit more flexible than mine. I rely on the generosity of my friends, we are fortunate to have family nearby. Luckily, when daycare opened up, I don’t know what I would do if my son were old enough to be in school, and that he got out at three o’clock and have your daycare open until 5:30 is my favorite thing in the world.

Sujani 18:10
I will soon find that out.

Joanna 18:12
Yes, I squeal in at 5:27. Last kid there.

Sujani 18:19
You know, I asked this question to some of my other guests, because of the pandemic. How do you see the workforce kind of changing? And I’m curious, you know, within public health law, and also kind of talking about the increased workload that everyone has taken on since the pandemic, do you see more opportunities in health law? Because, you know, you kind of said that there’s only one individual within your division? Do you see that perhaps expanding? Or do you think things will go back to quote unquote, normal workload?

Joanna 18:49
I definitely see it expanding. You know, I was talking to my friend the other day, and she said, you cannot keep being the singular point of failure for all of this at it. It’s so true, right? One person should not be the only one who does this work. It’s really a systemic failure at that point, right.

Sujani 19:12
Yeah.

Joanna 19:12
So you know, I am working with- with my leadership to get some additional support to train up someone else who can take a little bit of that pressure off of me as well and, and have someone who knows the ins and outs, but gosh, the first time I went on vacation, I had three people covering for me. And they were all my bosses, right? Because, God forbid I had someone under me who had to cover for me, they wouldn’t know what to do.

Sujani 19:38
Yeah.

Joanna 19:38
So I was like, Okay, you cover this part. You cover this part and you cover this part.

Sujani 19:43
Yeah, no, that’s good to hear, at least for those thinking about this profession, I guess as a lawyer in public health, that there are more opportunities that will kind of likely come up.

Joanna 19:54
Yeah, I certainly hope so. I certainly certainly hope so.

Sujani 19:58
When we talked about the health law degre mentioned a few additional topics like malpractice and a few others. I’m sure a lot of your you know, school classmates kind of took different directions even within health law, is that something that you’re aware of and able to share a bit about what other paths there are for anyone interested in that public health law?

Joanna 20:20
Sure, of course. So one of my classmates works for a hospital system in privacy and compliance. Two of my classmates work for federal agencies, another one of my classmates works in medical malpractice law. One works in tech, not within my class, but I know of a couple others who work in hospital systems. I have previous colleagues who work in hospital systems as well. And that is typically where most people go.

Sujani 20:47
Yeah, I think the tech line is also very neat. I’m seeing a lot of kind of healthcare startups also coming out now. So I suppose there will be a lot of opportunities there as well.

Joanna 21:01
Yes.

Sujani 21:03
Yeah. What did you wish that you knew before you got into public health law that you could kind of pass on to those who are early in their journey, trying to find their dream job towards this help law intersection?

Joanna 21:18
Moreso what I would pay attention to or learn more about is a lot of the data privacy, and the tech contracting the tech issues, I would try to find more training on that. That is definitely not readily available, at least for free, you know, for government employees. So that is, that is something that I would encourage anyone looking to get into this field to focus on because it is a big part of my work. And something I work on on a daily basis.

Sujani 21:52
Do you mean kind of like the new technology that’s coming up and being well versed in that? Is that what you’re referring to when you say-

Joanna 21:59
Yeah, and public health contracts with a lot of tech companies. So being able to negotiate tech contracts.

Sujani 22:07
Right.

Joanna 22:08
That’s, that’s part of my job. So knowing how to do that, that’s not something you typically learn how to do in law school. And it’s not something that most other lawyers know how to do. I have a wonderful colleague, who is fantastic at that, but it’s not her job to train me how to do it. And now she is onto another job, and she’s much too busy to hold my hands through it. So I would encourage anyone out there to you know, really consider that that is a huge part of where public health is nowadays.

Sujani 22:38
Right, no. That’s a really good point. And you know, having done it now yourself, can you kind of point people to some resources or any creative ways to gain that type of, I guess, experience or knowledge? Other than kind of doing it yourself?

Joanna 22:57
Yeah, I’m just just doing it.

Sujani 22:59
Yeah. Because I’m kind of thinking for those who are graduating or are about to graduate and thinking about, okay, how can I have a leg up?

Joanna 23:08
So I think most law schools now I would say, pay attention in your contracting course. Law schools do have contract drafting courses, take that and take any technology courses that you can. That would be my advice.

Sujani 23:20
Okay. So there’s also this other interesting fact about you that you are a co author of a very cute book, Pandemics for Babies. I bought that for my son or actually, it was gifted to me by my- Yeah, epidemiology friends. So I read that to my son, pretty much, I think, week one, so he knows all about it. Yeah, and then Neal’s episode released, so folks can definitely listen to that. But you are the other author of that episode. So maybe we’ll hear from your perspective, what was it like being an author of that book and also being in public health and also having a son? I think it’s probably- Yeah, it was probably very fulfilling for you.

Joanna 24:03
Yeah. It was fun. I haven’t listened to Neal’s episode. So I don’t know he told you about, you know how we came up with the idea. We were in New York, right after they were announcing the first few cases, right in the start of 2020. And we had read a few of Chris Berry’s books to our own son. And we’re like, wow, wouldn’t it be cool to you know, do some- some public health books for babies?

Sujani 24:30
Yeah.

Joanna 24:30
And we, we jotted them down. And we sent them off to the publisher, and she wrote back a few weeks later, and we turned them around pretty quickly. So we were writing them in April 2020. And they came out in October 2020.

Sujani 24:48
Yeah.

Joanna 24:50
It is a quick turnaround. Yeah, so we were writing them like, I mean, at the absolute worst possible time. Just work wise, the absolute.

Sujani 25:00
Yeah.

Joanna 25:01
So day care shutdown, working around the clock, sniping at each other the absolute worst thing. Last thing we wanted to do was like spend more time together, right?

Sujani 25:14
Yeah.

Joanna 25:15
Feels like you need to look at like the mock ups. And I’m like, I don’t even want to look at you. Let alone look at mock ups. I’m like, okay, so we share an office. Neal, and I, and I’m usually at the desk, and he stands and puts his computer on the filing cabinet, which is right next to the desk, and he would turn the computer towards me, and I’m like, looks great, fantastic. Awesome. But we would go back and forth on the illustrations. And Chris Ferrie did all the illustrations, and he did a fantastic job. And we were always in complete agreement. And honestly, it was a relatively painless process. It was super fun. It was pretty quick. The editing back and forth took a little bit longer. But the writing of the illustrations was- was pretty painless and quick. And it was- it was really enjoyable. We had a good time. Yeah.

Sujani 26:09
Yeah, I remember Neal saying that, you know, he had to kind of hold his breath when it was getting published. Because you don’t know who’s going to come back and say, oh, no, you said this wrong. Did your lawyer hat come on quite a bit while you were drafting the manuscript for this?

Joanna 26:26
Oh, all the time,

Sujani 26:27
All the time?

Joanna 26:29
All the time. And we did a lot of media around it, too. And my lawyer hat was on all the time with the media outreach and the interviews we did. Said that said that? So yeah. That’s a second guessing, of course, negotiated our publishing contract. And of course, almost blew that out of the water, you know, still brings that up.

Sujani 26:55
Yeah, I think because public health was under so much scrutiny. It’s like even the smallest sentence that you have in that children’s book. I’m sure you know, you had to hold your breath every time you are thinking about people reading each of those sentences.

Joanna 27:10
Yeah.

Sujani 27:11
Yeah. I remember my brother in law picked it up a couple of weeks ago. And he was like, okay, this is fantastic, even for us adults to just kind of understand what just happened.

Joanna 27:22
I just use great outdoor workouts with this wonderful group of women. Run by these two great moms. And one of them was like, you should actually call this pandemics for dumb moms. This was like the best way to explain it. To me, that was like number one, you’re not dumb. But I am gonna subtitle it like that. She was like, every page I was like.

Sujani 27:47
Yeah, it just simplifies the message. Kind of explains why public health was telling you to do X, Y and Zed.

Joanna 27:55
Exactly, exactly. Yeah, hers was honestly the best feedback I’ve ever gotten. It made me so happy.

Sujani 28:02
Yeah. Well, it was a great book. I loved it. And it sits on my son’s shelf, although I want to move it to mine.

Joanna 28:11
Thank you very much. That’s wonderful.

Sujani 28:14
Thanks so much, Joanna. I am sure you know, this episode is going to help a ton of individuals kind of exploring this field of health live. I know personally, a few individuals who have shared that they are interested in becoming lawyers after pursuing a Master’s of Public Health. So super excited to get this episode out to those folks. And I guess just any last words of advice or anything that you’d like to share for those interested in a similar path as yours?

Joanna 28:42
Just that I think there’s a ton of different ways to be a health lawyer. And any way to give back and to improve the health of the population, or law through advocacy is very important. So I’m here to support any way that I can, greatly to help.

Sujani 29:00
Thank you so much.

Joanna 29:01
Thank you.

Sujani 29:04
Hey, so I hope you enjoyed that episode. And if you want to get the links and information mentioned in today’s episode, you can head over to pHspot.org/podcast. And we’ll have everything there for you. And before you go, I wanted to let you know about the career program that we run here at PH SPOT. If you’ve been feeling overwhelmed and uncertain about building your dream public health career, then we can help you through this program. It’s an intensive hands on training program for early public health professionals. And this includes recent graduates and students. And you can now join the waitlist at pHspot.org/program. And you’ll be notified when the next cohort opens up. And until next time, thank you so much for tuning into PH SPOTlight, and for the invaluable work that you do for this world.