Health tech and the intersection of medicine, public health, and entrepreneurship, with Dr. Jennifer Monti, MD, MPH

Dr. Jennifer 0:00
Defining problems clearly, thinking about how you might go about testing them, thinking hard about data quality. And then on the backside of that, right, is how you’re going to distribute this thing out into the world in a way that number one has impact. And number two probably needs to be monetizable. If you’re thinking about it as a company or part of a company, or maybe doesn’t, right, which is a great thing about public health is if you can find the kind of mutually beneficial partnership. These things are like multipliers.

Sujani 0:33
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.

Welcome, Jennifer to the PH SPOT podcast, really looking forward to talking about this topic of Health Tech with you today.

Dr. Jennifer 0:56
Happy to be here.

Sujani 0:57
So you come with a background in medicine. And you’re also very much interested in kind of that intersection of medicine, public health and entrepreneurship. And we’re gonna dive into that quite a bit in today’s episode, but I’m curious on a personal level, when did you discover that this idea of public health or this kind of like field existed?

Dr. Jennifer 1:21
Thanks for the question, it’s really important. And this really hit me in the head when I was in medical school in Cleveland. So I went to medical school at Case Western Reserve. And I spent most of my time at the Cleveland Clinic. And this is an interesting program, about 30 of us who ultimately get our degrees that case, but also spend all of our time learning in this really big world class health system. And I’d be in the Cleveland Clinic. And then I would walk out to my car on East 100 and Fifth Street, between the clinic and Case Western’s campus. It is a neighborhood that struggles. And you could live in fill the gap, right between the tremendous resources on the medical and biomedical side of the house, and the desert, right, of connecting all those resources to sort of impacting that local community. Every institution’s mission is different, right? Not everyone is trying to serve all the time, the people right outside the door, and it’s hard work. But for me, 24 years old, right, starting medical school, that was a really wonderful incubator for these types of relationships and observations, because you had the clinic and University Hospital, that Case has these really excellent world class healthcare facilities, along with case being an engineering school. I mean, it trains excellent engineers. So I thought that along with an economy, I will say that was sort of struggling and thinking about how do you reinvent as a rust belt economy. So a lot of interest around startups and new ideas and how to take intellectual property out of these big institutions and build them to sort of rise all the boats, I think of what they say. So that’s one of the reasons it was a very grateful to have been there, that time to just be in that incubator of tech, medicine and the need work for entrepreneurship to help reinvent Northeast Ohio economy at that time,

Sujani 3:14
How early on in your training, as a doctor did this kind of experience take place?

Dr. Jennifer 3:19
I mean, this is like summer number one, I also had a little bit of a different journey to medical school, I took three years off between my undergraduate degree, which wasn’t, you know, biochemistry at Harvard, pretty traditional path. But I took three years off in the Bay Area. And this was the early 2000s, when you know, Tech was exploding. I think Facebook hadn’t been founded yet. And I worked for a little bit of a consulting group looking at early stage technologies, and how they would impact healthcare over time and how I thought about investment in them. So I came into medicine with a pretty different lens about what you could do there. And also to some sort of, you know, the personal story of how I end up in medical school to begin with, I think it was a really interesting sort of connection. So I’m very grateful for having taken that time. I think it made me a better student, a better thinker, and overall, sort of more impactful in my career over time that those first couple of years right out of the gate were really important for how I view what’s the work worth doing at this point.

Sujani 4:15
So up until the experience you had just seeing the world outside of the clinic. Was that concept of public health foreign to you like was it after that point, that you kind of started researching, learning about it, maybe like talking to people about this concept of public health?

Dr. Jennifer 4:34
Not so much a foreign as a field of study that to be the most useful physician I could be. I would have to know about, right. I mean, you can’t be you can’t be in your clinic day after de seeing hyper and obesity and all of this stuff and not say oh my gosh, what do we do further upstream? And how do we build bigger systems and make the big investment announced that we are going to change the face of this. So I think, for me to fulfill my, it sounds kind of corny, but my oath as a physician and public health is intimately related to that they cannot be separate.

Sujani 5:13
Yeah, absolutely. And I noticed that you ended up doing it, mph MD degree. And you know, at what point did that kind of realization hit you was it fairly early as well?

Dr. Jennifer 5:24
Right off the bat, because I get that, and I say, oh, my gosh, you can do extra degrees for free, right? But and I was also I was in a five year program, which was unique. So I had to do a research here, knows- NIH track. And I said, Jeepers, between, you know, the four years and the extra year, I certainly have time to do that. And I also saw joining a degree program as a way to structure my reading. I mean, I’m a reader, I think to be in the field. And as kind of sensitive to these circumstances that you may not live in that we try to address often in public health, you have to be a reader, right. And I already had that in me. And I saw it as a group of professionals, a lot of folks in the program had come back, or were working part time, somewhere like me joint degree, but I thought, these are my people. This is where I’m going to structure my reading. And that kind of community of practitioners, that was like a bonus on top of medical school, like I couldn’t believe that you could do these things. The program director at the time, Dr. Scott Franklin, extremely influential on how I think now he just retired, but a giant in the Cleveland area, I remember walking into his office and saying, Here’s what I want to do, here’s what interests me, and he was like, okay, you know, I think he was like, we’ve got a live wire here, you know. So we built with me sort of a unique pathway through that, that really radically informs basically, every day of my life, at this point, very influential.

Sujani 6:47
And how many of your peers also thought that way and decided to go through that dual degree?

Dr. Jennifer 6:52
There were a handful, and we had a bunch of mock and you can do more engineering, sort of master level engineering type degrees, you could do an MBA, if you wanted, you could do a degree in ethics, there really was like every case was like a buffet of interesting. And I think as medical students, you know, the time if you were strategic, and you started early, and you knew what made you hungry, there are a lot of things you could do. I also had worked for three years, right? Like I was hungry, like yes, you know, medical school takes time management, and it’s a lot of work. But I was hungry for our community and projects of relevance right away. And I think part of doing a joint degree helped fulfill those needs.

Sujani 7:30
Yeah, I think that real life world experience kind of really adds to how more clearer you become, are some of the next steps you want to take. And I kind of share my story from time to time to say, like, if I were to do it again, I probably wouldn’t have jumped into my masters right after my undergrad, I would have taken some time to work and experience the field a little bit more. And I’m hearing that more and more for those of us who kind of went through that path.

Dr. Jennifer 7:57
Yeah, I mean, God, God Willing- Life is really, really long, right? So two or three formative years before pursuing graduate school – changing? I don’t think anything else can you know, the value of doing work being on a team, I really encourage that along with a gap year, you know, for your younger listeners who may be sort of high school into- into undergrad, that concept of a gap here has been around for a very long time, just not as prominent in the United States. But I think it’s a fantastic idea.

Sujani 8:23
Yeah. So you graduated in 2010, from your MD MPH degree, and then kind of follow your journey as to like what you’ve done. And it’s not the traditional route that you would what- you would expect a physician to follow. And for those of our listeners who may not have Jennifer’s LinkedIn open in front of them, you kind of have roles that range from being a founder to you know, physician and cardiology, you were a board member, your co founder you were what other things do I see here? You’re- you’re in a health tech role right now you’re part of Maine Angel. So tell us you know, what happened 2010 Onwards to where we are today.

Dr. Jennifer 9:06
It’s really interesting to come out of training. And the most important thing, if you are interested in clinical medicine is that you’ll be excellently trained, period. And I remember going into my residency being like, Oh, God, I don’t want to do this, for variety of reasons. And I had a really wise mentor who was like, what you learn in residency is who is sick and who is not. And there is no way to know it, except putting in the time. So she gave me a prompt attitude adjustment. And then I did my residency in Baltimore, which again, a part of the reason I did that it is a public health contrast, right? I mean, you have the most powerful probably the most powerful School of Public Health in the world, in Baltimore, sitting in some of the most, you know, under resourced, challenged neighborhoods in our country. So again, I was really attracted to that contrast and thought, well, if I’m going to learn medicine anywhere, this is going to be a very smart place to do it because public health is sort of CO elevated as a field while doing my clinical training. I also mentioned having to enter the fifth year as a medical student that I had to do. And it was going to be a research year. And it was clear to me I was not going to be on the bench, you know, I was not going to be in a lab. That’s not how I wanted to spend the time. So I spent it as a deputy to the Commissioner of Public Health in Baltimore City, who was Josh Sharfstein, and he had worked for Senator Waxman. Long time before that. So he ran that office, like a congressional office. So I really got to see what it meant to respond to things in real time, you know, what it meant to try to do long term planning with difficult budget circumstances. And there were two projects at that time that really stuck out for me and then influenced, you know, the rest of that training and how I organized my training. One was the hot day bus problem, right? In other words, that the over 105, we need the buses to be free, and we need the cooling centers to be open. It was sort of like, Jen, can you take care of that? And I’m sort of being like, Okay, right. I know that, that feeling that type of responsibility for that type of logistic, you know, related to help, right, like those all hydrated and hot and, you know, that really sticks with me, as I would not have had that experience otherwise, which then informs what comes later. And then the project I actually spent most of my time on, which was actually my public health degree capstone project, I was able to do that. And that as one project – Was mapping food deserts. So I think most of your listeners may be familiar with that concept. But for those who aren’t, the idea of a food desert, is basically looking at the distance from a proper supermarket in urban areas. And if you don’t have a proper supermarket, it’s linked to all of the poor health outcomes that I think we’re pretty familiar with. So in mapping the city, you know, I looked at I lived in what’s called the, you know, Inner Harbor, Federal Hill, the inner neighborhoods that tend to be a little bit better resourced, and I looked at mapping across the city. So you could have lots of grocery stores down in the Inner Harbor. And then just as you got out towards Roland Park, and some of the outer neighborhoods, it started to be quite bountiful. And then between those two was a desert, gigantic desert. And we said, how are we going to get at this, there was a local supermarket who delivered which at that time was kind of thought of as a community service, you know, they did have their regular old people. And they had an online ordering platform. So this is 15 years ago at this point. And I said, they were called Santonio, it’s a local family. And I said, All right, you know, they’re delivering to one family in that tower, that’s public housing. What if we get everybody ordering on the platform, waive the delivery fee, or make it one delivery fee, right, because that total, that public housing unit might be 600 bucks for everybody, that total for one house, and Roland Park is probably 550. Right. So if we can just bring some parity to the logistics around ordering, it’s still technically one address. But this is really the idea of the profits under the pyramid, right? And that’s I read as a student that I probably quote, once a week and have bought 40 copies of for other people, right? The idea that if we build products and services for people at the top of the pyramid, then that’s very few people. But if you’re able to build products and services that are more low cost, and scalable, you’re gonna take care of a lot of people, you’re gonna make a bunch of money, and you’re gonna serve a lot of people well, so we applied that in Baltimore. So having spent that year in Baltimore with Josh, was, I can’t really over state how important that was, because when I then become a resident, learning my medicine there every night, you know, every third night at that point, to already have that intimate knowledge of the city, where I was learning that craft was extremely powerful. And what it did also was, I should share between that time with Josh, and the time that I took off and lived in the Bay Area previous to starting school, I was sort of ripe to have a decent idea come out of my brain at some point soon, right? Like, yeah, getting my clinical chops, understanding my community. And it happened one night in the cardiac ICU, taking care of another heart attack patient. And I tell you, it’s a half baked idea at the time, but it took that much time. The founders are 42 or 43 years old, right? Most unicorns are not by people that are 20 in hoodies, they are 42 to 45 years old, because it takes a while to have a really deep, narrow experience that is valuable usually. But you know, for the clinical folks in the house, they’ll appreciate this, that guy has a heart attack, he’s sitting in the bed, and I’m saying to myself, well, his heart is having trouble, but the rest of his vasculature actually works quite well. And if we can there particular types of cells that live in the vasculature that if you can get them out into circulation, they can find their way to damage tissue and do a lot of good. And one way that egress happens is exercise, right? And obviously, my heart attack patient in room seven is not going to exercise. But could we build a device that could stimulate the musculature in large vessels? In a way that kind of seems like exercise enough stimulate egress of these cells. I get hot on this idea because of my one patient. And I call over to the engineering school at Hopkins and this is the Beginning of my third year, and I say, Look, I don’t know if you ever have engineering teams that work on things, but I’m a doctor. And here’s what I need. And the woman on the phone said, we have a bunch of teams, and no one ever calls. And I was like, what do you mean no one ever calls like, you guys are just sitting up there, full of interesting engineers, and I’m sitting here with a ton of problems to solve.

Sujani 15:19
Yeah.

Dr. Jennifer 15:19
So that first idea became the genesis of their capstone project. Engineering also uses that term. And we built the device, and we filed a provisional patent. And we did all this work together. And that was the first time I really led a team with a product focus.

Sujani 15:36
As you were doing clinical work, right?

Dr. Jennifer 15:38
Yeah. Right. So I’m a third year, then starting to, you know, the part of that kind of start to buff you up and shine you up, they’re ready to send you out. That was my first experience of who do I need to pull together in a team with a product focus to solve a large enough clinical problem that we can get some traction around. And it was by fire, no one hands you those- those roles, you have to create and show the value.

Sujani 16:01
The first thing that comes to mind is that you said you picked up the phone and called somebody I don’t know if anybody ever does that anymore. It’s always just like, shoot off an email. And that gets lost in somebody’s inbox. But that’s a golden piece of advice. If there’s a phone number, pick up the phone and call somebody because no one’s doing that these days.

Dr. Jennifer 16:17
And I still know these guys that were on my they were undergrads, I was a resident and I followed them, one of them started a successful company that uses AI to characterize that wound feeling over time. So you do those things, the most interesting things in your career are gonna be the peripherals that you choose to spend extra time on, right? Because we’ve got a lot of good options in your life, and you have to follow the thing that just gets you out of bed every day.

Sujani 16:40
Think back to your I think you said it was a mentor of yours, when you told him, you know, you don’t want to be here. And he said, You’re just here to learn medicine. And for you, and maybe, you know, has there been advice that you’ve passed on to some of the mentees in your life where they’re kind of itching to get out of this, like training that they’re in that they’ve already kind of invested a bit of time in? Because they know this is not what they’re meant to do? And there’s something more out there for them. But, you know, you’re always in that – That like moment of frustration, where you’re like, I know, I kind of have to stick it through here. But I also know I will have to do something else. But I don’t know what that something else is?

Dr. Jennifer 17:20
It’s a really important question, because it’s true in every field. I mean, I definitely had moments in my training where I was like, Oh, this is just not what I wanted. And there’s nothing I would rather be in my identity and my core being than a cardiologist. So I knew the art was right at the time was hard. And it’s going to be true in any field. But you need to get an expertise, right? Because when people are building teams down the road, they’re going to try to slot you or when you’re building a team. You don’t want to be too much of a generalist that somebody can’t say, oh, yeah, you know, that’s my GIS woman or oh, yeah. You know, she was responsible for x at y company, resulting in G amount of growth. I think there’s a risk in public health, we say to general that we don’t have that narrow accountability to something. I mean, how I was feeling as a second or third year resident is exactly the way a junior person at Bain feels. It’s the same way. You know, an apprentice an electrical apprentice feels because you want to get move in. Right? You’re hungry, but you got to know what you’re doing. Right? So I had great mentors, and which was Dr. Goldfarb. She’s a pediatric infectious disease doctor who probably doesn’t even remember me, but I remember her. Right? Because she was probably a you know, I don’t know when her 50s Little bit of gray hair, who was like, Listen, kid, this is the nugget. And I have repeated time and time again, you know, because she’s exactly right. You have the same feeling when you’re in attending my first day attending, right? I’ve been through internal medicine training, I’ve been through, you know, good cardiology fellowship, I’m well prepared. And I was like, Oh, my God, what do I do when it’s finally you? You know, it’s different. The one thing I do say, though, in terms of medical training, particularly to people early is if it’s just not in you, leave, because sure, we make a nice salary. And it’s a delightful profession. But it’s hard. And it’s not a calling, leave now. Because no one cares at your doctor except your mama. That’s what I’ll say. Right? Like, it’s got to be deeply in you. Otherwise, you really should do something else, a lot of good ways to have an impact on the world. That’s what I Yeah, it’s certainly not for everybody, and it’s changing so much that I feel for these young ones, you know, kind of not that old, you know, I’m 42 but the you know, I feel for people just starting out wondering what it’s gonna look like in the United either the US side of the house and I think it’s going to take some real guts from clinical people who know what they’re doing to serve people and reinvent the model and and do the right thing and a smart strategic way.

Sujani 19:48
And there’s lots of smart people out there I think these kind of like, have to find each other build that tribe and push through.

Dr. Jennifer 19:56
To be quite bright. Yeah, right. I mean, doing anything new is incredibly hard. Pushing the envelope in any ecosystem is very hard. And that’s what the tribe is worth did you need people cheering you on.

Sujani 20:09
That phone call that you made to the engineering department and you kind of expressed your sentiment of you guys have a lot of people that can build. And we have a lot of people that know the problems. And that’s kind of how I feel with even public health professionals, right? Like, they’re a bunch of very passionate individuals on the ground at various levels of government, or not for profit organizations, and, you know, day in and day out, they’re seeing all the areas that could be improved, they kind of know those areas in and out. And some of them are itching to be the solution for those problems. And to those individuals who, as may not have an a direct phone line into an engineering department, I don’t know if you have any advice for those of us whose kind of, you know, work on whatever the problem may be right, like sexually transmitted illnesses, or wildfire, or foodborne outbreaks, or whatever it is, how does one kind of take that first step when they realize okay, enough is enough? I’ve seen this problem, year after year, I want to do something about it.

Dr. Jennifer 21:17
Yeah, this might seem like a funny answer. But the number one thing I would say is, if you’ve looked around a whole lot, think about starting a company.

Sujani 21:26
Yeah.

Dr. Jennifer 21:26
Or number two, think about joining a place that is resourced enough to help to build you to solve the problem at scale. And this is where I’ve landed just because we’ve seen the relative decimation of the public health sector over time, in terms of resources. And I think COVID is unique. And we’re going to start to see it withdrawal of some of that, that resource we already have. At the same time when I say that you also have to think about staffing, the really local city national levels of public health organizations doing the work on the ground. What I say to people in this situation is narrow the problem specifically, right, like the desk, the problem is I die so bad and okay, what specifically, what is the core there where you think there might be the intersection of the things that you mentioned, when you introduce me? What is the intersection of the medicine interest, the public health interests and the entrepreneurial interests, where we might be able to launch that idea in a way that we can get it resource? When I say entrepreneurship, or start a company, I’m not that everything has to be some, you know, massive exit. That’s not what company building is, it may be enough to build a small, nimble, profitable group that is solving a problem in public health. That’s so deeply rewarding. The term has kind of got so hot, it’s like hot right now. Oh, startups and entrepreneurship. And, for me, I’ve noticed just means taking risks with someone else’s money. Right? That’s all that it means. But that mindset of people who approach problem-

Sujani 23:02
Yeah.

Dr. Jennifer 23:02
-with lens, I think, is very powerful, no matter where you look at it. So two people, and this is what I wish for. I wish I heard from more people in public. Right now I’m sitting on it, I kind of keep a small group of us that will kick ideas around, we have four or five ideas and concepts that we think could be company. So we’re gonna need to staff those, right. So not only do I want to hear ideas from people, we need to pull out of the public health ecosystem, people that are willing to to describe their expertise and how they might fit into that ecosystem.

Sujani 23:35
Excellent.

Dr. Jennifer 23:36
As you started out, saying, you know, sometimes it’s more health promotion, or, you know, working in a, in a data function within a large organization. Those are important, but I think that you said at the beginning, also, our schools are not necessarily preparing public health graduates to be successful in traditional or non traditional roles. And I think I would start with it. The only criticism I would have of my own training, and this is a long time ago, when I was in public health school was the data science aspect was not mature. It’s my hope that you know, and leading schools, that has probably matured quite a bit for people with a public health lens. But it may also be not the most comfortable field for some people interested in public health. But we’ve got to make sure that anybody worked in a public health field is- is data competent, you do not have to be PhD statistics, but data conversion, so we make sure that we’re asking good questions, solve the problems that we’re seeing.

Sujani 24:28
I’m glad you brought that up. And I am curious to get into that a little bit more, in addition to, you know, being data literate, what other I guess skill sets are you seeing as being a need in some of these tech companies that are recruiting for individuals with some sort of Public Health Training?

Dr. Jennifer 24:48
I think that there’s a lot of money sloshing around tech and healthcare or public health, and they don’t know what problems to solve. The most compelling thing there is not data analytics or who builds the machine learning. What question are you asking? What are the inputs, right, to models people are trying to build? What is data quality, right? Because all of these systems have like an EMR, electronic medical record, it’s garbage in, garbage out. Right? And I think that’s a really unique skills for public health folks in defining problems clearly thinking about how you might go about testing them thinking hard about data quality. And then on the backside of that, right is how you’re going to distribute this thing out into the world in a way that number one has impacted. Number two probably needs to be monetizable. If you’re thinking about it as a company, or part of a company, or maybe it doesn’t, right, which is a great thing about public health is if you can find a kind of mutually beneficial partnership. These things are like multipliers, the book I mentioned, the author of the pyramid book I mentioned is CK Prahalad: P R A, H, A L, A, D, and please she was at the University of Chicago, he died, passed away recently gives these examples of people whosolves problems in this way. And the partner would often be like Unilever, you know, these huge companies. And the example that they’ll give is leverage Pantene at some type of shampoo, or they observed in developing economies that look, people wanted shampoo, they just were not going to buy a $3 big thing of it. So they would sell it in packets, right. And they saw enormous growth and like that little part of their company by taking a different approach like that. So I think when we’re looking for people to be attracted, and companies or product based companies just think about the inputs and think about the outputs, how was Unilever thinking about how they distributed, you know, shampoo, I remember when I was in training, and traveling quite a bit. In developing nations, you’d say, the Koch truck seems to get everywhere, right. So when we’re talking about things, vaccine distribution, or housing is gonna get somewhere like, I don’t know, I’ll call Coke, they seem to know how to get there. Public health is a beautiful field, because it’s wildly cross functional. And to be successful, you’re going to have to work across a bunch of stakeholders. And I think that’s a unique skill set that we should sharpen. And it’s weird in public health to not for everybody, but I think it’s a little bit uncomfortable to think with a product focus. But I think, in the world that we’re living in, we’re gonna have to be able to more effectively tie to products and services that could be done in a lot of ways. I can imagine a lot of different ways to help people sharpen their thinking around that. Maybe it’s a service, you know, I’m thinking about service. I’m kind of lumping it all in as product. But broadly speaking, what’s the product? What’s the service? And what is the right distribution channel? Even work inside the CDC or the, you know, City of Portland, where I live? Like, there’s a role for all of that type of thing?

Sujani 27:45
Yeah, there is. Absolutely. Are you seeing, I guess, I don’t know, if you’ve done much hiring of public health professionals in like non traditional roles, and you’re at Metro right now. Are you seeing that people with a public health background are able to just find the roles that are being put out by these tech companies? And I think what I’m trying to get at is, do they need to be a bit more strategic in the way they’re looking for these kinds of roles? Like, do the tech companies know who they’re looking for? And like, are the needs and the wants able to match up?

Dr. Jennifer 28:20
That’s a good question. I don’t know that I am the right person to answer that question. But I can, I will say this, I think if you have public health and medical type people on a on a team in a company, then that’s a that’s a tech company looking at the healthcare, right. And if you have people in medicine and public health, leading a company, that’s a public health health care company, who happens to need some tech to help it. And those are different things. Right. So I would urge people who are looking at companies, startups, big small, look at the leadership teams. You know, and who is active at the table? And think about it, you know, that’s an ecosystem that you’d likely to be successful.

Sujani 29:00
It goes back to something else you shared, where you kind of knew that Cardiology is what it is that you wanted to focus on. Right? So I think getting getting clear of what it is that you want, will likely help you find that role that’s going to be a good fit for you.

Dr. Jennifer 29:15
I think that’s right, that it’s the- it’s the problem that gets you out of bed, the thing that you kind of can’t live with, right, try to build a career around that thing. And you’re always going to be emotionally connected to it in one way or another. Right. It’s not always high. For me, honestly, it was sudden cardiac arrest. Right. So the problem that that is for people who may not know is when somebody just sort of dies suddenly, particularly young people already have reasons. A lot of them are often genetic, and you’ll hear about them in the news or right it’ll be somebody LeBron James’s son, right. I suffered a cardiac arrest at a basketball practice, all sorts of reasons for those things, but, and I saw some pretty difficult cases, right and training and as an attending in the last decade, decade and a half. I can’t really live with that.

Sujani 29:55
Yeah.

Dr. Jennifer 29:55
So the first company that I founded when I was at Penn was directly related to some of these problems. And I could imagine building 10 businesses around that problem for people in public health and think about why- why did I get into this, you know, what really interests me? Go back to that route, and then look at companies that are directly addressing that problem. And you’re just going to end up in this whole ecosystem that you’d like a whole lot?

Sujani 30:22
Yeah.

Dr. Jennifer 30:22
The only thing I would say is, when you’re in school, your first couple of years out, is you’re gonna need a side project, right? Because that’s where the interesting pieces probably are, as you’re trying to really land on what your quote, career is going to be. Don’t work for free, but find interesting companies or opportunities, or maybe a unique discrete project that you can contribute to. So when are in the pile of applicants for a job at, you know, a company of 30 that’s growing, and then looking at the thing, and they’re like, Yeah, you know, undergrad, and then worked for a couple years, and then do a master’s of public health. But oh, actually spent three months interning at this little company in Pittsburgh. Tell me about that. Right, like, how do you get in the pile? And that’s what I did when I was coming up. I mean, I’ve always had that sort of discrete, a additional project, or part of your story that you could speak very fluidly to because you wouldn’t have had it without straight hustle. Does that make sense?

Sujani 31:22
Yeah.

Dr. Jennifer 31:22
People sort of light up when they talk about those things, right? That’s what you know, this particular project, like no, what did you go out and get hungry for, that’s the person I want to hire. That’s what comes out of when I’m, you know, reading through stacks of things, that’s who kind of pops out of the pot.

Sujani 31:36
You want the hiring manager to think what’s the number, it’s like five seconds that they spend on a resume, when they’re flipping through those five seconds, you want them to pick up something really unique off your resume.

Dr. Jennifer 31:47
Again, this guy that was at the Cleveland Clinic has my first summer research summer, basic scientists on the bench, he said, Look, when I have to read grant applications, that means I’m doing it on a Sunday. And that means my wife wants me to be painting the deck. So if I’m not going to be painting the deck, I better have something really interesting to tell her about the pile. And I have repeated that many times, you know, positioning, you know, is, is really important, right? And how you’re going to tell the story of how you’ve spent your time and where you’d like to head.

Sujani 32:15
I want to ask you one question. And then you know, I don’t know if you have the answer for it. So when you were running, I think it was called Hemos, that first company that you founded. And then I’m sure it was like a very medically focused product that you were building and you had an engineering team? Like, if you were to do that, again, would you have maybe like recruited folks that were more of like a public health trained group without medical training into that role? And you know, if so, what would have been like an ideal candidate?

Dr. Jennifer 32:49
That’s an interesting question I’m gonna answer in two parts. Because that company, I mean, we were looking at something pretty geeky,

Sujani 32:55
Yeah.

Dr. Jennifer 32:55
What we were looking at is non invasive hemodynamics. And how I can do something I have to do now. It’s called a right heart catheterization, which means to put a big needle in your neck or the grind, snake a tube up to your heart and measure the pressures in the heart and a bunch of derived variables. And trying to do that from the outside. So that was pretty, pretty unique. Where I would have, you know, imagining how far we would have gotten down the road is would have been very helpful to have public health minded and trained people thinking about the distribution and utilization of that data at scale across communities, because if we hit it out of the park that will be used at home. Right, you know, so that becomes home monitoring technology. So I think there’s a benefit in public health, training people to be working in those those ecosystems, right, where we’re trying to devices into the home and manage those devices. I mean, I want a public health person to go and manage a dense neighborhood in Brooklyn, for my company, right?

Sujani 33:56
Yeah.

Dr. Jennifer 33:56
So all right, how do we make sure that it’s being used correctly at the right time? You know, so that the data is flowing? And Doctor can- can act on it?

Sujani 34:05
Awesome.

Dr. Jennifer 34:06
That’s right. Like that’s how people that are public house trained, engaging with things like remote patient monitoring, monitoring companies, there’s like a value in that that can be described.

Sujani 34:17
Yeah. Like individuals who know how to engage with the community who know how to, like distribute these products and services to the people, right. And assuming that you’ve spent a number of years working with those populations and communities, you understand them a lot better.

Dr. Jennifer 34:31
Right. Most of them have a last mile problem, right? Like, it’s like buying an iPhone, it can show up at your house, and it’s beautiful box, and you open the box. And like if you don’t know what to do after you turn it on, it might just box right. That’s what a lot of, you know, what is- what does it mean to have real engagement? I mean, it’s the same health problem, except now there’s a bunch of tech.

Sujani 34:51
Yeah.

Dr. Jennifer 34:52
Right?

Sujani 34:52
Yeah.

Dr. Jennifer 34:53
Those are public health are the skills that are going to unlock the value. When these technical consumer based devices end up to ploy that skill. The second point I want to make sure that I capture is I think about down the road, probably starting another company, the ideas that I have, are the things I really want to work on are more tightly linked to public health concerns, would I start another hardcore medical device company? Like? Probably, right, if I- if I thought it was the right clear indication, but I think when I think about the next 10 years, or problems we’re solving, and then there are a lot of rich public health opportunities in there, and they might be hidden in things like infrastructure, or clean energy, those are all super resources right now. And they’re public health problem. How do we marry public health graduates to those impactful fields, not just to be on the team, with the team, start a team, right? Being on the team? Awesome, right? And I don’t mean to dismiss that. But how do we get people who have the public health impact at the core of their being, to have the skills to lead those teams, so that excites me very much.

Sujani 35:56
I love that. I love the- the note that we’re kind of wrapping up on. But I think for any of my listeners who kind of looked at your profile, they probably would want me to ask you what, you know, health tech at Meta means and what that kind of role looks like for somebody and you know, what was your decision to go into a company?

Dr. Jennifer 36:17
Yeah, it’s interesting. You know, I think that that is a brilliant company, for building for billions of people. And public health needs to do the same thing. And thinking at scale is something that I think we all could stand to do more of, because it’s going to take big time solutions to the public health problems that we’re seeing. So I one thing I say to people in public health often is, yes, I love that we think at the zip code level. And how do we think at scale? It’s gonna look a little bit different, right? Like we talked about communities. But how do we solve the problem for every single household in America? One of the things I know that was where I am right now, I think about that, in my own state, I live in a state that is 1.3 million people not that far from you live in Maine. And to give you a sense of that, the distance from the bottom of Maine to the top of Maine, is as far as Boston to Philadelphia. In other words, we only have 1.3 million people spread over and give you a comparison about 10 million people in New York City. Right? So how do we think about solving public health problems? At scale? Mindful of all those limitations, right deployment for 1.3 million people over that much area is going to be different than deployment for 10 million people in New York City.

Sujani 37:42
Yeah.

Dr. Jennifer 37:43
But we have got to stitch together products and services of value that we’re going to be able to deploy at those numbers. That kind of excites me about the intersection of public health thinks at scale like that, right? For everybody. But deployment, and the kind of highly local nature of some of it is super interesting and super hard.

Sujani 38:02
Yeah. And you’ve kind of already alluded to this. But you know, there is space for non medically trained public health professionals in companies like Meta.

Dr. Jennifer 38:12
I think that tech companies like people who know about data, and you think about data, they think about problems like this is all tech companies, like think about problems like data quality.

Sujani 38:20
Yeah.

Dr. Jennifer 38:21
Think about problems that affect a whole lot of people. The company is, sure, but I think you’re referring to but what is really a kind of consumer tech company.

Sujani 38:29
Yeah.

Dr. Jennifer 38:30
But the company that monitors the water in the sewer outside my house, that’s a tech company these days, right? I mean, I think we need public health people expanding their notion of where they’re willing to work. I wish that there were public health people working for my municipal water system, because they would learn so much right about the nuts and bolts of that infrastructure that they would then be very attractive, whatever tech companies looking to put sensors on every new pipe that’s going to go into Jackson, Mississippi, because they haven’t had clean water for five years.

Sujani 39:01
Yeah.

Dr. Jennifer 39:01
Right. Like that, to me is what if I was coming out, you know, not so much clinically oriented, public health minded, and I have somewhere to go and learn. And someone asked me, What should I do? I would say, go work for a bridge building company or a water company, right? Like, because there’s a lot of value in that.

Sujani 39:19
Yeah.

Dr. Jennifer 39:20
And that is that that’s what like we this country, and I’m thinking about us focus, but there’s in the next 10 or 20 or 30 years with rebuilding infrastructure that is instantly related to public health.

Sujani 39:30
How do we make that happen, Jennifer, like, you know, the people trained in public health, they know they can fit themselves anywhere, literally. But these companies, these organizations, institutions who can’t really see that and make that connection, how do we make that happen?

Dr. Jennifer 39:48
I think that it has to start with where people if they are in school, or working in these places, is we need to expand the number of mentors that are willing to put these seeds in people’s minds. Like if you- if after this podcast, five people were to call me and be like, I want to work for the water company, I’ll be like, Alright, here we go, you know, and it may take a phone call from somebody who knows somebody to get you in the door, because they’re like, why is this kid calling to want to work here, that doesn’t make any sense. To me, it makes tons of sense. It’s just going to take, you know, that person in a master’s program who’d like to show up for three to six months to be putting in the work to be in overalls underground with them, not just the data person right up in the office, but actually in there with the techs understanding how it works, that’s when you’re gonna you bring those beginners eyes to those ecosystems. And you’re gonna notice all sorts of problems. I mean, that’s how I came up with a novel concept for a device in cardiac ICU where I had been for six months. I didn’t know why not.

Sujani 40:49
Yeah.

Dr. Jennifer 40:50
At the end of the right, I was kind of what’s this? What’s this? Like? What do you mean, there’s no technology to solve that problem I just asked you about

Sujani 40:56
Yeah.

Dr. Jennifer 40:57
And like, boom, that’s the connection.

Sujani 40:59
Yeah.

Dr. Jennifer 40:59
The other thing I also want to add is, as people are thinking about this is, Do not be afraid to go outside of the traditional large ecosystems-

Sujani 41:07
Yes.

Dr. Jennifer 41:08
-where people are working, right. So I get it. Like I moved to San Francisco, I went to college in Boston and moved to San Francisco, like the day after. But there is so much value, both technical and problems we’re solving in that what people might refer to as like a second tier city, but I came up in them Cleveland for medical school, Baltimore for residency, I then did my fellowship at Penn and Philadelphia, the technical expertise at a place like case right there all over the place. There’s Purdue, Carnegie Mellon, RIT, like these great engineering schools align with that. One of the reasons I moved to Portland, as a physician just out of training was I there was so much opportunity to care for people because it had been relatively underserved. I was able to to move into leadership positions or, you know, take on these great roles caring for families that if I had stayed in Philadelphia, or Boston, or a more traditional academic path, I don’t think I would have been first in mind just by nature of the number of people in life, right? I mean, you could be that someone could probably be the director of public health in a small town within a few years by putting in the work and being present much different, right than being on a team at the New York Public Health Department, which is an amazing institution doing amazing work, and the path would look much different.

Sujani 42:25
Yeah.

Dr. Jennifer 42:25
It takes some guts to do that. But I actually think in the end, you’re you’re more competitive, because you’ve you’ve kind of navigated to a leadership role, more, nimbly, maybe, or maybe a little bit sooner, not everybody, but that’s a different story to tell.

Sujani 42:40
Yeah.

Dr. Jennifer 42:41
Take the gap of someone who decides I want to do a PhD program. Alright, so now you’re in the pile of 15 applicants to the Ph. D. program, one spent, you know, three years on a team at the Gates Foundation. Important work, amazing, great network. Another says I was the deputy health commissioner in Indian Falls, New York. My partner’s from Indian Falls New York and graduated 15 People in our high school class, right, it gives you-

Sujani 43:07
Yeah.

Dr. Jennifer 43:07
That’s like different experiences. So if I’m looking at those two things, I’m like, Whoa, tell me about Indian Falls, New York. They just- It take some guts, and but there’s just so much value. And particularly I live in a state where I live in the most rural state east of the Mississippi, right, the problems of rural America, I don’t even know what that means. There’s so much technical expertise and know how that we need to link very smart people to some of the problems that caused the sort of rural urban divide, whatever that means, you know, because there’s so much talent sitting out, waiting to be harvested that we need, people going there and recognizing the value and building systems that make people stay and work and live there.

Sujani 43:47
That’s golden advice. And one thing that just popped out kind of as an obvious thing, when you were saying all of this is, you know, if you’re- if you’re looking for grad school, you know, public health grad school, say, and you’re itching to solve, like a tech problem, then find a really good engineering school, even if the school of public health isn’t one of the top ones. Because you’re going to be able to merge those two departments and build something they’re like the connections you’re going to get, they’re going to take you closer to that next step where maybe you’re trying to solve a problem that is the intersection of like public health and finances like find a university that can help you meet the people that you need to achieve some of these goals.

Dr. Jennifer 44:32
I want to give an example briefly of two companies that were started in the Portland area that in my mind are public health companies, you know, and if you’re on the early on one of those ecosystems, you can participate in building those you know what it’s called Forerunner, a company that looks at floodplain management, and helping cities most of our customers are in you know, Louisiana, Florida, helping people understand floodplain risk. That’s a public health company. There is a company called Circa, C-I-R-C-A, it is a company that recognize how far people fall behind on their rent, right? In other words, if the rent of 1000 bucks and I can’t make it, I don’t pay anything. And she said, What if you could pay some of it? Right? Like, would that allow people to stay housed longer? Right? Like, look, landlord, I’ve only got 700. But wouldn’t you rather have that than nothing. And she built a mobile platform to do that for renters. And that is a win win situation, right. But these companies are coming up in, no one’s looking at Portland, Maine to be a hotbed of startups. And this was true when I got here seven years ago, it’s gotten there’s all this maturity, and I’m very bullish on the ecosystem. But those are public health companies coming out of a place that you would not expect. We don’t have an anchor institution. I mean, we have the University of Southern Maine, but the University of Maine is two and a half hours north. It’s a fantastic engineering school, I would like everyone listening to go there and to talk to me about it, because it’s a total gem. These are the types of things that are on my mind for public health thinkers.

Sujani 45:57
Yeah. I also want to encourage folks to listen to a couple of episodes of our a little bit more than couple when this goes out, as we sat down and talk to Josh, founder of About Fresh and I don’t know, Jennifer, if you’ve heard of About Fresh or Fresh Connect, but it’s a tech enabled food prescription program. Yeah. So incredible story there too. And, you know, similar themes that we’re talking about here, on the ground, seeing the problem, rooted in public health, you know, starts with one idea then grows into something else, and just being aware of the problems around you and knowing that you can find the resources and the people to solve those problems.

Dr. Jennifer 46:34
That’s right, trust your instincts, because you’re probably right, particularly people that have not been in a field very long.

Sujani 46:38
Yeah.

Dr. Jennifer 46:39
This is like why residents and fellows around when I’m rounding because, again, they haven’t really seen it, or they- They see something and they’re not really sure. And they’re kind of afraid to say it out loud, as they say it because you’re probably right.

Sujani 46:49
Yeah.

Dr. Jennifer 46:49
Then you go and think about how you might soften.

Sujani 46:52
Amazing thank you so much, Jennifer, this has been such a wonderful conversation. And I know there’s going to be a lot that a lot of people are going to pull out of there, I wouldn’t be surprised if you’re going to receive a number of LinkedIn connections as well when this goes out.

Dr. Jennifer 47:07
No, it’s a joy of my career at this point is to talk to young people who want to build things. So thank you.

Sujani 47:14
Hey, I hope you enjoyed that episode. And if you want to get the links or 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 want to tell you about the public health career club. So if you’ve been looking for a place to connect and build meaningful relationships with other public health professionals, from all around the world, you should join us in the public health career club. We launched the club with the vision of becoming the number one hangout spot dedicated to building and growing your dream public health career. And in addition to being able to connect and build those meaningful relationships with other public health professionals, the club also offers other great resources for your career growth and success, like mindset coaching, job preparation, clinics, and career growth strategy sessions in the form of trainings and talks, all delivered by experts and inspiring individuals in these areas. So if you want to learn more or want to join the club, you can visit our page at pHspot.org/club. And we’ll have all the information there. And you know, as a space that’s being intentionally curated to bring together like minded public health professionals who are not only there to push themselves to become the best versions of themselves, but also each other. And with that, I can’t wait to see how this is going to have a ripple effect in the world as we all work together to better the health of our populations and just have immense impact in the world. And I hope you’ll be joining us in the public health career Club.