Member Spotlight: Monica Bharel

February 09, 2017 | ASTHO Staff

Monica Bharel, MD, is commissioner of the Massachusetts Department of Public Health. As commissioner, she is responsible for spearheading the state’s response to the opioid crisis, as well as leading the department’s implementation of healthcare cost containment legislation, Chapter 224, reducing health disparities, finding public health solutions for healthcare reform, finding innovative solutions using data and evidence-based practices, and other healthcare quality improvement initiatives.

What was the experience or motivating factor that compelled you to become a state health official?

I’ve been exposed to the power of public health throughout my career, from my experience in college working to build housing for homeless elderly women, to my years as a physician witnessing the impact that poor health and education opportunities had on my patients. I’ve always enjoyed the great privilege of the one-on-one relationships with patients in a clinical setting. One constant in my work over the years—in city hospitals, the Veterans Administration, neighborhood health centers, and street-level medical outreach—is that I have always been drawn to moving upstream of the disease manifestations I see in my patients and seeking to address the underlying social determinants which can play such a critical role in giving these patients the true opportunity for health.

Was there someone who influenced you to lead a health department?

Mentorship has been an important part of my career path. My dad, a hardworking independent internist for a diverse group of patients in Queens, New York, was my first mentor in the field. The frontline nurses and doctors, who I have had the privilege to work side-by-side with, taught me so much about being present with patients and their families and were devoted to curing disease and relieving suffering. I have also been fortunate to have exceptional role models in both the health and medical fields in Massachusetts who have always inspired me to think beyond what we believe is possible.

All that said, my most important influences have always been my patients. Through them, I learned that the true definition of health is much broader than being disease-free, and that the basic desire to have opportunities for good health for ourselves and our families is common to us all, regardless of our backgrounds, economic status, or where we live.

What other positions you have held at a public health department?

This is my first time having the privilege to serve in state government. Although I spent years advocating for public health issues from outside of government, I feel extremely fortunate to now work within government to give a voice to the issues I have seen through the eyes of my patients while in clinical practice.

What is your morning ritual?

I’m a late-night worker and have always valued the quiet of night to reflect on the activity of the day. My husband and I have two school-age children so our morning consists of getting the four of us out the door in an orchestrated frenzy. If I can find 10-15 minutes to exercise in the morning, I consider it a real win.

What do you do to stay healthy?

I love to exercise, but I must admit that I have found it hard to fit into the busy life of a commissioner. I’m trying to get creative about incorporating fitness into my daily routine and even have a desk bike underneath my conference table. I do my best to eat healthy, get enough sleep, and always try to make time to connect with my family and friends.

Where is your favorite vacation spot?

I don’t think I could pick just one! I’ve had the immense good fortune to travel to many areas of the world. Although there are incredible sights to see all over the world, I am most interested in the people I meet along the way. It’s a reminder to me that no matter how different our external appearances, the human spirit is more alike than it is different, no matter where we come from.

Why is health important to you?

One of the things you learn quickly in medical school and clinical training is just how many devastating diseases there are and how important it is to diagnose and treat those diseases. However, one also learns the burden of disease disproportionately falls on those who are most vulnerable. Promoting and preserving health among populations who live on the margins of our society is a key aspect that draws me to the work of public health. One of my favorite motivational quotes by Dr. Martin Luther King, Jr. speaks to the need to address these unequal burdens: “Of all the forms of inequality, injustice in health is the most shocking and inhumane.”

What are your favorite hobbies?

In my precious free time I make it a point to stay connected with my family and friends, who are my real source of spiritual nourishment and help me maintain a healthy balance in my life. When time permits, I love to travel, cook, hike, and take photographs.

What do you love most about the public health work you do?

I have always dedicated my work to align with my life mission of fighting inequity and avoidable suffering. The people I work with in public health every day are incredibly dedicated to advancing health equity and protecting and promoting health for all of the residents of our state. I feel incredibly fortunate to be able to work beside these passionate and talented individuals who are truly making a difference in the lives of so many.

What do you find most challenging about public health?

Public health is about prevention. And because we are preventing something before it occurs, it is sometimes hard to measure our progress or effectively communicate our impact. I believe that, in order to be successful in the future, we will need to enhance our ability to use big data to tell our stories, share our successes, and work across multiple sectors to measure our success.

What are your primary public health priorities?

My public health priorities focus on four areas: data, determinants, disparities, and drugs. In Massachusetts we are fighting a devastating opioid epidemic that is killing almost five people every day. We have implemented a cross-sector response focused on prevention, intervention treatment, and recovery. This includes education on opioids for students, athletes, coaches, their parents, and healthcare providers, a revamped prescription monitoring program for prescribers, increased access to naloxone across the state, and more treatment and recovery options for individuals afflicted by the medical disease of substance use disorder.

As we tackle complex public health issues such as substance use disorder, we will need to thoroughly understand the problem before we determine where to deploy our limited resources. This will require the enhanced use of data and data analytics, a focus on the social determinants of health, and unearthing disparities where we can focus or hotspot resources with an ultimate goal of eradicating health inequities.

What is something you’re most thankful to have been a part of during your career in public health?

I feel very fortunate to come to the department of public health after having spent several decades immersed in the healthcare system. This has allowed me to bring to the job a true understanding of the patient-level experience of the healthcare system. Through my work with underserved populations, I have been able to gain an appreciation of where healthcare intersects with public health and the many challenges individuals have in maintaining health when the social determinants of health make this so challenging. This understanding from my individual patients has truly enriched my capacity to understand the underlying problems deeply and continues to inform my approach to health policy every day.