From the Back of an Ambulance to Capitol Hill: RWJF Fellows Program Director Gregg Margolis on His Career Journey

For nearly 50 years, the Robert Wood Johnson Foundation (RWJF) Health Policy Fellows program has sought to build a strong, diverse network of leaders and maintain a workforce skilled in health policy. By connecting health professionals with the opportunity to participate firsthand in the federal policy process, this nonpartisan program aims to improve health equity, care, and policy. To learn more about the fellowship experience, we hear from Gregg Margolis, a fellow from the class of 2009–2010, who returned to become director of the program in 2017. In the interview below, he discusses the transformative experience many fellows have in the program and what they can bring to the federal health policy environment.

Gregg Margolis began his paramedic and health care career seemingly by chance. As an adventure sport lover, he worked his way through undergraduate studies as a scuba instructor.?He became an emergency medical technician in case he ever had to take care of?a scuba student if they were injured while?out on the water. Margolis quickly developed a passion for having an impact on people’s lives while working in the emergency medical services (EMS) field. Then, a mentor encouraged him to apply for the RWJF Health Policy Fellows program—an experience he ultimately found to be transformative. When the fellowship ended, Margolis decided to do something he never expected: stay in Washington, DC. Just like in mountain climbing, another one of his hobbies, he found that many seemingly small steps strung together led him to cover a lot of ground, and he now enjoys a fulfilling career as director of the program he once joined as a fellow. Below, he shares his journey to, through, and beyond the program, as well as advice for prospective fellows

You were the first paramedic to become a fellow in this program. How did your EMS skills prepare you for the fellowship?

Being a paramedic and a flight paramedic were important early experiences for me and a lot of the skills that I developed as a clinician—being able to remain calm under pressure, communicate clearly, analyze a complex situation, decide what is relevant, and figure out what needs to be done first—laid a strong foundation for my career. You often need those same skills in policy work.

What surprises you about where you are today?

When I started as a paramedic, I never in a million years thought my career would take me to national policy work and the opportunity to work in Congress, the presidential administration, and the White House “situation room” during incidents. Each one of my career steps has felt logical at the time, a bit like mountain climbing: one step leads to another and to another, and then, suddenly, it's surprising how much ground you have covered.

What is it like being the director of a program where you were once a fellow?

When I was a fellow, I had enormous admiration for then-director of the program, Marie Michnich. She had a big influence in my career and I remember telling my wife, “Marie’s got a really cool job.” The opportunity to follow in her footsteps and build on the program that she and others created is a real honor.

The director position is an amazing opportunity to interact with the nation's leading experts on health policy. It’s a ringside seat to a lot of the nation's most important health policy debates. However, I think the most satisfying thing to me is the opportunity to work with amazing fellows who want to do incredible things. I’m grateful for the chance to get to know them and play a part in that process.

You’re an adventure junkie who has been to the base camp of Mount Everest. What was it like transitioning to office-based policy work?

The outdoors and adventure sports are still an important part of my life. I do a lot of outdoor activities, but nothing quite as extreme as what I used to do, and I don't have as much time for them. I still work as a ski patroller at a local ski resort, which gives me a chance to take care of patients, be outside in the winter, and ski. Fortunately, my family is also really interested in adventure sports, so we do a lot of outdoor activities together.

The RWJF Health Policy Fellows Program allows health professionals to apply their expertise to policy making. How does the U.S. government benefit from the perspective of paramedics and other clinical professionals?

There are lots of fellowship programs in Washington, DC. Most of them are for people right out of graduate school. They are fantastic ways for people to get involved in policy work early in their careers. The genius of this program is that it is designed for people with extensive experience in health and health care. These extraordinarily accomplished professionals bring a perspective that is often absent from policy debates. The ability to say, “This all sound great on paper, but let me tell you how this is going to end up being implemented in the real world,” makes our fellows highly valued.

Perhaps even more impactful,?because of their career and fellowship experiences,?our alumni are extremely effective at influencing federal, state, local, institutional, and professional policy for the remainder of their career.?

Where are fellows typically placed during the program?

This is a non-partisan fellowship and our fellows can serve placements in many senior governmental roles. About 90% opt for placements in congressional personal offices or committees. We really strive for both bicameral and bipartisan placements. Two fellows are working on the U.S. House of Representatives’ Energy and Commerce Committee—one of the main House committees with jurisdiction for health. We have a fellow working for the Speaker of the House, and three fellows in personal offices in the Senate side.

“I have seen firsthand that most of the people working in Congress really go to work every day to solve problems and improve the country.”

Do you think fellowship programs like this one can help heal the partisan fractures in Washington by moving us toward common policy goals?

Yes, but I’m not na?ve. Like a lot of people, I was pretty skeptical of the federal government, politicians, and the political process when I came to Washington, DC, for the fellowship. Even with the increased polarization that dominates the front pages, I’m way more optimistic now than I was then. Most people are surprised to see how much policy making still gets negotiated and passed on a bipartisan basis. I have seen firsthand that most of the people working in Congress really go to work every day to solve problems and improve the country. Even when they disagree, most work hard to “find a path forward.”?That may not make the news, and staffers are the unsung heroes of the policy process. I think if more people had this experience, it would help heal our divisions.

What else should we know about the RWJF Health Policy Fellows Program?

I am pleased about our recent efforts to strengthen the fairness and equity focus of the fellowship experience. We have long been committed to making sure that our fellowship brings diverse perspectives. We seek diversity not only in regards to race, ethnicity, and gender, but disciplinary, geographic, and ideological diversity. We seek applicants who offer a different way of thinking, a different lived experience, and a different angle on health and health care that we haven't fully explored.

“The fellowship literally changed the trajectory of my career.”

How did the fellows program affect your career as a whole?

Wow. The fellowship literally changed the trajectory of my career. I hit the jackpot both in terms of timing and placement. I was a fellow in the 2009–2010 class and worked in Congress during the passage of the Affordable Care Act. I served my placement with Senator John Rockefeller (D-WV), who was Chair of the Health Subcommittee on Senate Finance. It was a pretty exciting place to be. I expected the fellowship to be a one-year learning experience and had planned to return to my previous position at the end of the fellowship. But I realized I had an opportunity to make a difference on a larger scale. During the year, I was fortunate enough to meet Dr. Nicole Lurie, who was the Assistant Secretary for Preparedness and Response. She had an interest in my EMS background and let me extend my placement to work in her office. I planned to stay an extra three months, and ended up staying there for seven years!

How did you make use of the fellowship alumni network?

The caliber of the network is unbelievable. For example, Andy Bindman was a fellow in my cohort—he was already a world-renowned health services researcher before the fellowship. He became the Director of the Agency for Healthcare Research and Quality and is now the Executive Vice President and Chief Medical Officer for Kaiser Foundation Health Plan and Hospitals. I don’t think there is a single area in health care and health policy where someone in our alumni network doesn’t have expertise. No matter what the issue is, you can go through the alumni directory and find a few people who are experts. It really is amazing.

What advice would you give to individuals who are considering applying to the program?

My advice is to go for it. The concern that “they will never take someone like me” is common—I had that thought myself and now I am the director of the program! And, as the director, I can tell you that the selection committee is often looking for someone just like you! Don’t overthink it. Just put your best foot forward because there is little to lose and so much to gain.

Learn more about RWJF Health Policy Fellows by following our LinkedIn Showcase Page!

We appreciate your support in building a strong and diverse network of leaders and maintaining a workforce skilled in health policy. Email [email protected] for questions about program opportunities.