Scientist at Work: Dr. Thomas R. Frieden Obamas C.D.C. Director, Wielding a Big Broom
(if: Maybe we should be writing to Dr Frieden as well. He wasn't on my radar before I saw this article.)
By GARDINER HARRIS
Published: March 15, 2010 in the nyTimes
ATLANTA No federal health agency changed more during the Bush administration than the Centers for Disease Control and Prevention. It got new buildings, new managers and an entirely new operating structure.
SWEEPING Since arriving at the Centers for Disease Control and Prevention in June, Dr. Thomas R. Frieden has scrapped most of the Bush-era changes.
A year into the Obama administration, only the new buildings remain. Dr. Thomas R. Frieden, the agencys director since June, has quietly scrapped nearly all the administrative changes that the previous director, Dr. Julie L. Gerberding, spent much of her six-year tenure conceiving and carrying out.
Gone are the nonscientific managers whom Dr. Gerberding sprinkled throughout the agencys top ranks. Gone is a layer of bureaucracy, agency officials said. Gone, too, are the captains chairs with cup holders from a conference room so fancy that agency managers dubbed it the Crown Room.
In their place, Dr. Frieden has restored not only much of the agencys previous organizational structure and scientific managers, but also its drab furniture. And he has brought something new: a frenetic sense of urgency.
The C.D.C. is considered one of the worlds premier public health agencies, responsible for tracking the spread of infectious disease, distributing vaccines and monitoring the causes of sickness and deaths. About three-quarters of its $10 billion annual budget is given out in grants to places like state and local health departments, which collectively lost 16,000 positions last year, according to a recent public health survey, making those grants that much more important.
Dr. Frieden, 49, a former New York City health commissioner, marches around the agencys Atlanta campus so rapidly that staffers have to trot to keep up. He uses his BlackBerry constantly, sending a stream of brief e-mail messages that are so cryptic that recipients sometimes ask for translations. Kmi, for instance, means keep me informed.
By the end of her tenure, Dr. Gerberding had become so removed from day-to-day management that some top agency officials went weeks without seeing or hearing from her, they said. Dr. Frieden, by contrast, sometimes wanders the agencys hallways and drops in on scientists unannounced to ask about their work, both delighting and terrifying them.
In an interview last month, in his 12th-floor office, Dr. Frieden said that when he arrived in June, there was near-universal agreement that change was needed, but nobody wanted a repeat of the disruption Dr. Gerberdings years-long reorganization had wrought.
Faced with that, you pull off the Band-Aid quickly, Dr. Frieden said.
Within two months, Dr. Frieden eliminated the coordinating centers, a layer of management Dr. Gerberding had added between the agencys scientists and top leadership. The Coordinating Center for Infectious Diseases, with 600 employees, became the Office of Infectious Diseases, with 12. No one was fired; the agencys leadership was simply pared.
Now president of Merck Vaccines, Dr. Gerberding said in an e-mailed statement: The 9/11 and anthrax attacks, SARS, and other global health threats altered the landscape of public health forever and made it necessary for C.D.C. to work faster and more synergistically to protect health than it had before. That was the intent of the reorganization. Im sure the new ideas that Dr. Frieden is introducing are motivated by the same intent."
Agency employees and former leaders said in interviews that they were thrilled with Dr. Friedens changes.
I think hes doing a great job, said Dr. Jeffrey P. Koplan, one of five former C.D.C. directors who had publicly criticized Dr. Gerberdings leadership. He is setting priorities and sticking to them.
Part of the agencys embrace of Dr. Frieden probably has to do with politics. Despite being in a Republican state, the disease centers staff, like much of the public health world, is overwhelmingly Democratic, so employees tend to prefer directors appointed by Democratic presidents. Also, Dr. Frieden began his career in 1990 as an officer in the Epidemic Intelligence Service of the C.D.C. at New York Citys health department, doing the base-level tracking of diseases that is fundamental to the agency.
Dr. Frieden said that among his priorities for the agency, the most important are improving its disease tracking and supporting state and local government health offices.
All of public health starts with more information, he said. We have to analyze what we have better and disseminate it better.
And with the poor economy and mounting deficits straining budgets, Dr. Frieden has been scrutinizing the C.D.C for savings to pay for his priorities.
Some agency officials panicked when Dr. Frieden asked each to plan for a 3 percent budget cut. The exercise found few easy cuts and fewer still that could be used to finance other programs.
We have very little flexibility to move money around, Dr. Frieden said.
Although he now lives in the South, Dr. Frieden is still very much a New Yorker. He returns from visits to New York with bags of bagels. He speaks longingly of New Yorks neighborhoods, and, in a series of meetings on Feb. 24, repeatedly referred to his experiences as the citys health commissioner.
One of the lessons from New York, he said, is that many of the programs that have the greatest impact on public health get the least attention. During his eight-year tenure there, for instance, smoking rates among teenagers declined while colon cancer screening efforts climbed, he said. Neither got much publicity, he said, sounding somewhat wounded.
He promised to continue focusing on basic tasks like getting those people at risk of heart attacks to take aspirin; those with high blood pressure to get treatment; and those who smoke to stop.
In New York, Dr. Frieden came under fire for, according to some critics, acting like a nanny and a scold with campaigns to ban trans fats, post calorie counts in chain restaurants, reduce salt in processed food and tax high-calorie sodas. He had a supportive boss in Mayor Michael R. Bloomberg and a receptive populace in New York, but if he were to try anything similar at the C.D.C., tough Congressional hearings could be in his future because conservative lawmakers on Capitol Hill often oppose such measures.
Dr. Frieden rarely discusses his family publicly, and he dismissed questions about how his wife and two children were coping with the move to Atlanta by saying, Moves are always transitions, and they can be difficult. Agency officials said that the stream of e-mail messages from him tapers off between 6 and 9 p.m., when he is with family.
His days are filled with short meetings in which he quickly makes his points and leaves at the appointed times. When the 25 minutes allotted for an interview ended, he got up, shook hands and left.
Theres a time to make things happen, Dr. Frieden said, and if you miss the wave, youre not going get stuff done.
A version of this article appeared in print on March 16, 2010, on page D5 of the New York edition.
(if: Maybe we should be writing to Dr Frieden as well. He wasn't on my radar before I saw this article.)
By GARDINER HARRIS
Published: March 15, 2010 in the nyTimes
ATLANTA No federal health agency changed more during the Bush administration than the Centers for Disease Control and Prevention. It got new buildings, new managers and an entirely new operating structure.
SWEEPING Since arriving at the Centers for Disease Control and Prevention in June, Dr. Thomas R. Frieden has scrapped most of the Bush-era changes.
A year into the Obama administration, only the new buildings remain. Dr. Thomas R. Frieden, the agencys director since June, has quietly scrapped nearly all the administrative changes that the previous director, Dr. Julie L. Gerberding, spent much of her six-year tenure conceiving and carrying out.
Gone are the nonscientific managers whom Dr. Gerberding sprinkled throughout the agencys top ranks. Gone is a layer of bureaucracy, agency officials said. Gone, too, are the captains chairs with cup holders from a conference room so fancy that agency managers dubbed it the Crown Room.
In their place, Dr. Frieden has restored not only much of the agencys previous organizational structure and scientific managers, but also its drab furniture. And he has brought something new: a frenetic sense of urgency.
The C.D.C. is considered one of the worlds premier public health agencies, responsible for tracking the spread of infectious disease, distributing vaccines and monitoring the causes of sickness and deaths. About three-quarters of its $10 billion annual budget is given out in grants to places like state and local health departments, which collectively lost 16,000 positions last year, according to a recent public health survey, making those grants that much more important.
Dr. Frieden, 49, a former New York City health commissioner, marches around the agencys Atlanta campus so rapidly that staffers have to trot to keep up. He uses his BlackBerry constantly, sending a stream of brief e-mail messages that are so cryptic that recipients sometimes ask for translations. Kmi, for instance, means keep me informed.
By the end of her tenure, Dr. Gerberding had become so removed from day-to-day management that some top agency officials went weeks without seeing or hearing from her, they said. Dr. Frieden, by contrast, sometimes wanders the agencys hallways and drops in on scientists unannounced to ask about their work, both delighting and terrifying them.
In an interview last month, in his 12th-floor office, Dr. Frieden said that when he arrived in June, there was near-universal agreement that change was needed, but nobody wanted a repeat of the disruption Dr. Gerberdings years-long reorganization had wrought.
Faced with that, you pull off the Band-Aid quickly, Dr. Frieden said.
Within two months, Dr. Frieden eliminated the coordinating centers, a layer of management Dr. Gerberding had added between the agencys scientists and top leadership. The Coordinating Center for Infectious Diseases, with 600 employees, became the Office of Infectious Diseases, with 12. No one was fired; the agencys leadership was simply pared.
Now president of Merck Vaccines, Dr. Gerberding said in an e-mailed statement: The 9/11 and anthrax attacks, SARS, and other global health threats altered the landscape of public health forever and made it necessary for C.D.C. to work faster and more synergistically to protect health than it had before. That was the intent of the reorganization. Im sure the new ideas that Dr. Frieden is introducing are motivated by the same intent."
Agency employees and former leaders said in interviews that they were thrilled with Dr. Friedens changes.
I think hes doing a great job, said Dr. Jeffrey P. Koplan, one of five former C.D.C. directors who had publicly criticized Dr. Gerberdings leadership. He is setting priorities and sticking to them.
Part of the agencys embrace of Dr. Frieden probably has to do with politics. Despite being in a Republican state, the disease centers staff, like much of the public health world, is overwhelmingly Democratic, so employees tend to prefer directors appointed by Democratic presidents. Also, Dr. Frieden began his career in 1990 as an officer in the Epidemic Intelligence Service of the C.D.C. at New York Citys health department, doing the base-level tracking of diseases that is fundamental to the agency.
Dr. Frieden said that among his priorities for the agency, the most important are improving its disease tracking and supporting state and local government health offices.
All of public health starts with more information, he said. We have to analyze what we have better and disseminate it better.
And with the poor economy and mounting deficits straining budgets, Dr. Frieden has been scrutinizing the C.D.C for savings to pay for his priorities.
Some agency officials panicked when Dr. Frieden asked each to plan for a 3 percent budget cut. The exercise found few easy cuts and fewer still that could be used to finance other programs.
We have very little flexibility to move money around, Dr. Frieden said.
Although he now lives in the South, Dr. Frieden is still very much a New Yorker. He returns from visits to New York with bags of bagels. He speaks longingly of New Yorks neighborhoods, and, in a series of meetings on Feb. 24, repeatedly referred to his experiences as the citys health commissioner.
One of the lessons from New York, he said, is that many of the programs that have the greatest impact on public health get the least attention. During his eight-year tenure there, for instance, smoking rates among teenagers declined while colon cancer screening efforts climbed, he said. Neither got much publicity, he said, sounding somewhat wounded.
He promised to continue focusing on basic tasks like getting those people at risk of heart attacks to take aspirin; those with high blood pressure to get treatment; and those who smoke to stop.
In New York, Dr. Frieden came under fire for, according to some critics, acting like a nanny and a scold with campaigns to ban trans fats, post calorie counts in chain restaurants, reduce salt in processed food and tax high-calorie sodas. He had a supportive boss in Mayor Michael R. Bloomberg and a receptive populace in New York, but if he were to try anything similar at the C.D.C., tough Congressional hearings could be in his future because conservative lawmakers on Capitol Hill often oppose such measures.
Dr. Frieden rarely discusses his family publicly, and he dismissed questions about how his wife and two children were coping with the move to Atlanta by saying, Moves are always transitions, and they can be difficult. Agency officials said that the stream of e-mail messages from him tapers off between 6 and 9 p.m., when he is with family.
His days are filled with short meetings in which he quickly makes his points and leaves at the appointed times. When the 25 minutes allotted for an interview ended, he got up, shook hands and left.
Theres a time to make things happen, Dr. Frieden said, and if you miss the wave, youre not going get stuff done.
A version of this article appeared in print on March 16, 2010, on page D5 of the New York edition.
