Being Transformative with LaQuandra Nesbitt

Director of the DC Department of Health Dr. LaQuandra Nesbitt didn’t always know she wanted to work in public policy. A lover of math and science who grew up in a STEM- focused household, she went on to earn her medical degree and began working as a physician. She noticed the institutional issues that were affecting her patients, and wondered how she could be a part of a bigger, more long-term solution. Today, she leads the way for healthcare policy legislators and healthcare professionals in the DC area, creating large-scale changes that make a big impact. LaQuandra sat down with us to chat about her career journey. Along the way, she shared some advice about what to consider when changing to a new career path and the one thing you should do every day to be a great leader.

Eliza: You’ve been the Director of the DC Department of Health for almost three years now. What led you to this particular role?

LaQuandra: Taking this position felt like a coming home of sorts. I worked here with the DC Department of Health previously in a number of roles before being recruited to be the Director of the DOH in Louisville, Kentucky. Mayor Muriel Bowser extended this position to me when she was elected. I saw a chance to come back to an agency where I had some familiarity, now in a higher leadership role. I was eager to take on some unfinished business from a policy and legislative perspective, to work with some great colleagues who are still here, and to have a chance to make a difference in a city that I’m passionate about.

Eliza: What was it like to return to an organization in the top leadership role? Were you welcomed back immediately, or was there resistance to your new position?

LaQuandra: The team here has been very welcoming. Most people who worked with me before were immediately supportive of my return. Having worked here before has definitely been an added advantage, because I didn’t have to come in and learn everything from scratch; I was already aware of how the organization functioned and what its core mission was. When I started, I knew that I had to make some quick decisions about what the organization’s values were going to be under my leadership. I had to decide what we were going to do to change organizational culture in places where we were stagnant; how we would motivate staff who wanted to be leaders in innovation; and how we would nurture and grow our own talent to move them into future leadership roles. It’s been a major goal of mine to emphasize to my middle managers and senior leaders within the organization that we have a responsibility to be leaders and mentors, not just managers. It’s been a fulfilling challenge to work through these types of transformational leadership issues.

Eliza: So you’ve been very busy to say the least! What makes leadership in the public sector unique?

LaQuandra: Yes, it is busy! In the field of Public Health, there’s a lot of servant leadership that occurs. When you work in servant leadership, it’s very easy to spend all of your time and energy improving the lives of others. But oftentimes people don’t think about the investments that you need to make in yourself. As Director, I see it as my job to make sure that we are investing in our workforce in order for them to do service for others and be in service to others. So I’ve spent a lot of time in my tenure thinking about the organizational structure, thinking about professional and workforce development, scaling up for public health and healthcare innovations, and what it really means to be a 21st-century public health organization. I want to make sure that I’m not just thinking about those terms just in the abstract, but figuring out what my people can do on a daily basis to transform into those futuristic type roles.

Eliza: What’s something that you do for yourself, to make sure that you’re meeting your own expectations and continuing to grow as a leader?

LaQuandra: One of my tenets for being a great leader, and what I always tell the younger people on my team, is that I think people should read the newspaper every day. It keeps you abreast of all of the current issues and topics that are going on in the world around you, and it’s that intersectionality of what happens in the world that helps us think more creatively about our own industry. I serve on the editorial boards of journals and am involved in national and regional advisory boards and committees for the same reason. This helps me stay knowledgeable about not just current policy things but trends that are emerging both locally and nationally that will be critically relevant to my work.

Eliza: You were a practicing doctor before shifting to Public Health. What was it like to hang up your white coat?

LaQuandra: It wasn’t an easy or immediate transition, and it wasn’t what I would have seen myself doing 20 or even 10 years ago. When I first became interested in public health, I was actually interested in it from the data and the disease investigation perspective. I thought I might go into academic research. By the time I actually went to pursue my MPH, I was more interested in healthcare management and policy. During my residency program I witnessed so many patients with barriers to accessing the care they needed. Seeing that lack of access firsthand made it very clear to me that we need more physician executives who are involved in those processes. And so that began to be a bigger drive for me as opposed to the epidemiology and biostatistics type of work that drew me to the degree in the first place.

Eliza: Do you miss working in the field, or doing that kind of medical research?

LaQuandra: I am comfortable with where I am professionally right now, even if I was reluctant to let go of practicing medicine. Before taking this role, I had continued to be active in patient care, working on weekends or for one half day a week in the urgent care setting. I managed that balance for quite a few years, but now I have so many more tasks on a day to day basis, it’s hard to carve out time for patient care or be directly responsible for them in any way. In the role that I’m in now, all of the health professional boards in the District of Columbia are under my purview, as well as over 60 different health profession licenses and certifications. So I’m very involved in terms of helping health professionals to thrive and have successful careers here in the District, and for their patients to get great care as a result. I’m also the research administrator to a number of data analysts and biostatisticians on my team. We use their data to make decisions and inform policy, so it’s been a good marriage of those interests. And I actually maintained my board certification last year, so I’m qualified and capable of providing patient care still. You never know.

Eliza: Parachute works with a lot of clients who are hesitant to change career paths when they have already put in so much time, effort, and energy into professional degrees like medicine and law.  What advice would you give about extending your career beyond what you imagined it to be?

LaQuandra: This is a problem I often see with medical students choosing their residency. They’re ostensibly choosing between whether to be a surgeon, a family doctor, or a dermatologist. But what they’re really choosing is their lifestyle. How many hours a week will they work, how much money will they make, how many patients they’ll know on a first name basis will be determined by this decision. I would tell anyone making a career choice the same thing I tell them: you’ve invested too much time into becoming who you are to wake up every day and be unhappy. So you have to choose what’s right for you, even if it’s not the easiest path, or the one you first expected.  

If you’ve invested time in the acquisition of credentials, and you’re going to work every day unhappy, then that’s probably not something that you should be doing. There’s always a way to take the acquisition of the credentials that you have, whether they be an MD, a JD, or any advanced degree and look at the holistic experience that those degrees have conferred upon you. The technical skills that we acquire are easily communicated to the public, to our clients, and to our patients. But there are also the life skills that we’ve acquired, which are a little bit harder to identify. These are transferable skills that can be applied to whatever we believe our passion is in our next career choice. So when you’re trying to make those professional transitions, think about how to take whatever it is you have learned and the skills you have developed as a physician, a lawyer, a civil engineer, an accountant or an economist, and how you can package them in such a way that allows you to really go after what makes you happy.

Eliza: So true! Women in particular tend to have difficulty identifying their own skills, and seem to work twice as hard to pivot as they face implicit workplace biases. As a woman leader, how have you faced implicit bias?

LaQuandra: This is always a very challenging question, and I’m always very deliberate in trying to answer it. There’s this idea that clearly as a woman, I must have faced bias. But when I think about my personal experiences and career opportunities, I have not. The notion of competing in the workplace for a promotion, and losing it to a guy even if you were more qualified, I’ve personally never experienced so I can’t speak to it. As a woman who is a physician, by the time I went to medical school, my medical school class was half women and half men. There wasn’t a culture of the guys being better than the girls or thinking that their brains are better wired to understand science and medicine. I’ve been very fortunate in my career to not experience that. Even when I have felt that there were challenges with people who were training me or people that I’ve worked with, it has unfortunately been from other women. I’ve worked with women who were the first to work at their institution, and their trailblazing created immense opportunities for me and other women. So we came into the experience idolizing them, but they were beginning to feel crowded out, making the relationships challenging and seemingly unsupportive. I think it is critically important for women to support each other because there are women who have challenges with advancing in the workplace, and there are women who have challenges in their academic environments, and not everyone has been as fortunate as I have been. So I try to support them and help them navigate that terrain as much as I can.

Eliza: What do you expect your biggest challenge to be moving forward?

LaQuandra: I think my biggest challenge in the short and probably long term is to help people understand the context in which I live, work and have my professional existence. So much of the conversation in our country around health and healthcare is so divisive right now. We are all human beings so we all have our ideologies, but I think that when we bring our ideologies to the table first, we lose sight of what it’s really about. No matter what kind of partisan politics people subscribe to, I think we have to get down to the common denominator that we all want people to be healthy and to be treated with dignity and respect. If we start our policy discussions from there, then we should be able to come up with workable solutions in this country and in our local communities.

Eliza: This has been a fascinating look into your work. Thank you so much for your time today.

LaQuandra: Thank you for having me!