Michelle Fakler MPA/ID 2020 wants to marry the individual care of medicine with big-picture health planning.
By Robert O'Neill
May 21, 2020
Michelle Fakler MPA/ID 2020 loves surgery. She relishes being on the medical frontline and seeing the tangible impact that a doctor can have on a single patient. But Fakler, who will return to the final two years of her surgical residency after graduating from Harvard Kennedy School, also loves the bigger picture.
“I wanted to be able to think about a complex problem in health care and consider the effect of economics, social norms, and politics in this space,” says Fakler about her desire to complement her medical training with an MPA in international development.
“Because you can know the medicine and you can know the science. You can know those technically correct solutions to the specific health problem,” she says, “But if you don't understand people, if you don't understand policy, and if you don't understand economics, you're going to fall short of scaling your solution.”
Fakler was always drawn to the health field. Her undergraduate degree in medical anthropology brought her to India, where she studied the role of culture and social norms in the spread of HIV in rural areas. But she began to feel impatient.
“I thought, ‘I can approach it from a purely academic lens or I can be active and engage and do,’” she says. (“When you're, 19-years-old, that's where your brain is,” she jokes.) That’s when she pivoted toward medicine.
But as she moved through medical school, she was drawn to a more systemic approach. Her role models were what she calls “surgeon leaders”: “Individuals running hospitals, thinking about how we better deliver care, really being really critical of ourselves as providers. They really engaged in thinking about how we can be better and just really pushing that envelope.”
Fakler’s surgical residency brought her to Boston’s Beth Israel Deaconess Medical Center. But with her interest in international health and the construction of sturdier health systems never far from her mind, she decided to take the two years that residents often use to conduct laboratory research and pursue her MPA/ID.
“You're working with one patient and that's your focus in that moment. But in those interactions, you're moving the needle slowly,” Fakler says. For this reason, her focus is on making health systems work.
Fakler came to HKS with a shopping list of sorts—courses and skills she believed she needed, like Edward S. Mason Senior Lecturer Matt Andrews’ course in management in a development context (MLD-102) and Anna Lind Professor of the Practice of Global Leadership and Public Policy Samantha Power’s course on making change when change is hard (DPI-535). She found those skills, she says. But she found much more.
She has been emboldened, she says, to think on more ambitious levels than she imagined, wanting to be involved on long-term health plans at the national level.
“What are our health goals for the next 10 to 20 years? How do you create a pathway and a plan? How do you create contingency models so that you can withstand shocks?” Fakler asks. “I do think that that small projects are necessary, and small projects are how we get things moving. As providers, we do need to be thinking about a patient at a time, but you also need to have a plan and you need to have a vision. Being at Harvard Kennedy School and spending time at the Chan School of Public Health, I began to think more in that way.”
But Fakler says HKS also imbued her with the importance of intellectual humility. “I'm not coming out of the Kennedy school thinking, ‘Oh, that's how you do it!’ I'm coming out of the Kennedy school thinking I have a lot more to learn and I have a lot of listening to do. And so, while I do have my own big goals and lofty ideals, I want to enhance the people around me to meet theirs.”
For a while, Fakler will have to refocus on the patient directly in front of her. While still studying at HKS, she worked part-time at Beth Israel as it faced the worst of the COVID-19 onslaught, and she’ll return to the operating theater right after graduating. But the bigger picture is never too far from her thoughts.
“I’m looking to engage with organizations solving complex problems in health systems development and scaling surgical services,” she says. “It’s not an issue of how we get one American surgeon abroad, but rather how do we build training pipelines to train surgeons there?”