In 2005, Dora Hughes, BS ’92, MD, MPH, was working as deputy director of the Committee on Health, Education, Labor and Pensions in the U.S. Senate for the late Sen. Edward Kennedy when she met the then-junior senator from Illinois named Barack Obama.
“I was intrigued,” Hughes says. “He’s very charismatic, and he’s a visionary.” She interviewed with him and was invited to become his health policy adviser.
“I was able to help draft the first genomics bill,” she says. “He was the first [in the Congress] to focus on personalized medicine. He was the first to focus on avian flu. Sen. Obama was generally always on the cutting edge.”
Though she’d expected to work with him only a year to help establish his health policy platform — Hughes wanted to get back to clinical medicine — she stayed on for two. In 2007, when Obama announced his run for president, Hughes helped shape his national health platform and watched him win the White House.
“I’ve had the most extraordinary good fortune of being in the right place at the right time and having the right skill set and training,” Hughes says.
Science and policy intersect
Getting the right training started early, when Hughes entered Washington University in the fall of 1988 as a John B. Ervin Scholar. Hughes had excelled in math and science in high school and decided to study engineering.
“After about two years, I started to think that medicine might be a better fit,” Hughes says. “I preferred the human application [of science].” So, Hughes got on the pre-med track and switched her major from chemical engineering to engineering and policy. As part of the major, Hughes remembers taking classes in political science, economics (which she minored in) and law.
“That probably was even more influential on my career than having the engineering background,” Hughes says. “It opened my eyes to policy’s intersection with science and regulation.”
After graduating in 1992, Hughes returned to her native Tennessee and attended Vanderbilt University School of Medicine. She earned her medical degree in 1996 and went into a residency program at Brigham and Women’s Hospital (BWH) at Harvard Medical School.
During her second year of residency, after having issues with double vision, Hughes was diagnosed with multiple sclerosis.
“That was another defining moment, as it always is when a doctor becomes a patient,” Hughes says. “You start to recognize some of the deficiencies in the health-care system even for those of us who are very knowledgeable.”
Hughes was moved to start looking more closely at health-care inequalities. She found a mentor in attending physician JudyAnn Bigby, and under Bigby’s guidance reviewed medical charts and records to track disparities in health outcomes for low-income women at clinics affiliated with BWH.
At the end of her residency, the hospital offered Hughes a job, but she turned it down and instead went into Harvard’s master of public health program. “I wanted to continue working with Dr. Bigby after my residency, but she pushed me to get additional training,” Hughes says. “The [experience] opened my eyes to policy in a very different way. We were completely immersed.”
When she graduated from the program in 2000, Hughes worked two years at the Commonwealth Fund, a private group that works to ensure quality health-care access for everyone. Then Bigby, who would go on to become secretary of health for the state of Massachusetts, recommended Hughes for a job working with Sen. Kennedy.
“I just couldn’t pass up the opportunity,” Hughes says. So she moved to Washington.
The road to health reform
A few years later, Hughes joined then-Sen. Obama’s team, advising him on public health and policy in the face of national health challenges like avian flu and Hurricane Katrina.
“All of that was eventually trumped by helping with his campaign health platform and really thinking critically about how as a nation we could achieve universal health coverage,” Hughes says.
When Obama won the presidency, she was named counselor for science and public health to Secretary Kathleen Sebelius in the Department of Health and Human Services (HHS).
“It was a tremendous experience,” Hughes recalls. During her time at HHS, Hughes worked on implementing health reform and providing policy direction for other issues as they arose, like H1N1, outbreaks of food-borne illnesses and the BP oil spill.
Hughes assisted with the development and early implementation of the Affordable Care Act, and she held leadership roles on several White House groups, including the president’s Food Safety Working Group; the Committee on Science, Technology, Engineering, and Math Education; and the Childhood Obesity Task Force.
“This involvement really helped me understand the power of the federal government and how it could impact the everyday lives of Americans,” Hughes says.
At HHS, Hughes remembers scheduling first calls at 5:45 a.m. and having conference calls that started at 9:30 p.m. “There was a lot of sacrifice across the board for everyone,” Hughes says. “But we were very willing to serve for the common good. In some ways, I would say it was the same as working in residency.”
After getting married in 2009 and having her first child in 2010, though, Hughes’ packed schedule was suddenly coming at the expense of her family. So in 2012, before Obama’s second term began, Hughes left HHS.
Today, she is a senior health policy adviser in Sidley Austin’s Government Strategies practice, a part of a bipartisan law firm on K Street. She provides advice to clients on the implementation of the Affordable Care Act, including access and quality provisions. And she has helped organizations with federal health initiatives, such as those focused on the Ebola response, antimicrobial resistance and precision medicine.
“Sidley has allowed me to work across a number of areas,” Hughes says. “I’m still able to work on health-care quality issues, access issues and regulatory issues. And in some cases I’ve continued to work on issues that I’d started to work on while in the federal government.” Though the hours are still long, Hughes’ schedule is more flexible, allowing her more time for her family.
Hughes credits some of her becoming a D.C.-policy-insider to her start at Washington University. “As much as I enjoy clinical medicine, I’ve continued to pursue health and public policy issues as they pertain to medicine,” Hughes says. “And I’ve found that my early years at WashU and exposure to so many different subjects as part of the engineering and policy major really shaped my eventual career direction 20-some years later.”