Acting Deputy Director for Science and Medicine — David Goldstein

This week’s spotlight is on David Goldstein, a non-clinical occupational therapist who is now Acting Deputy Director for Science and Medicine for the Office of the Assistant Secretary for Health!

What is your full name, title, and company name for your current, primary role?

David Goldstein — Acting Deputy Director for Science and Medicine, Office of the Assistant Secretary for Health, U.S. Department of Health and Human Services (HHS)

Where are you located?

Washington, D.C.

Where did you go to OT school, and what year did you graduate?

Thomas Jefferson University, 2016.

What did you do when you first finished school, and for how long?

Immediately following graduation, I worked as an acute care occupational therapist at the University of California, San Diego (UCSD).

In what setting(s) did you work, and what types of patients did you treat?

I supported the UCSD Department of Rehabilitation across their hospital-based and outpatient services for patients with chronic complex care needs.

I treated patients across a diverse spectrum of diagnoses and care needs, including adults and children with severe burns, orthopedic polytrauma, cancer, cardiovascular diseases, neurological disorders and tumors.

What did you enjoy about your early roles? What didn’t you enjoy?

I greatly appreciated the hands-on experience I gained connecting what I had learned in graduate school with real-life treatment realities.

Working at an academic medical center in a major metropolitan region allowed such a diversity of practice opportunities and settings.

Additionally, I was able to interface across a myriad of professions, giving me deep knowledge of interprofessional roles and skills which I carry forward to my policy role today.

What else have you done since then, prior to your current role?

Prior arriving at the Office of the Assistant Secretary for Health, I had the privilege of serving as a public health adviser at the Center for Medicare and Medicaid Innovation (CMMI) and as Behavioral Health Lead for emerging work focused on behavioral health care delivery system transformation for those with unmet mental health and substance use disorder diagnoses.

My background also includes experience across the management consultant space supporting the Navy Bureau of Medicine’s Directorate of Healthcare Business in San Diego, focused on the development of a patient-centered medical home model for Navy (TRICARE) beneficiaries as well as advisory work with the Camden Coalition of Healthcare Providers on their academic and practice-based healthcare “Hotspotting” programs.

When and why did you decide to do something non-clinical?

After a number of years of clinical work across hospital and non-hospital settings, I got the itch to return to a role that would permit me to strategize and innovate the way in which the system transforms, and in turn meets the needs of those who seek care.

Part of this thought process for me was that I felt more comfortable impacting at the 30,000-foot vantage point than I did individual to individual.

I had big ideas, some of which I could engage with in a care delivery setting directly. However, many required me to move to organizations and into spaces where the goal was to think about the future of healthcare and to transform it so that future generations are cared for in improved ways that more effectively meet their needs.

What are you doing these days?

I currently work at the Office of the Assistant Secretary for Health. My office spends a lot of time focused on data-driven decision making in areas important to the American public.

Within this role, I advise the Assistant Secretary for Health, Deputy Assistant Secretary for Science and Medicine (DAS-S & M) as well as the Chief Medical Officer regarding program priorities covering the full range of public health activities within the HHS Office of the Assistant Secretary for Health, with a focus on those relating to:

• Public health innovation
• Clinical care delivery
• Healthcare payment and reimbursement policy
• The intersection of clinical care delivery and population health safety and preparedness

The Office of the Assistant Secretary for Health (OASH) oversees U.S. Department of Health and Human Services (HHS) key public health offices and programs, several Presidential and Secretarial advisory committees, 10 regional public health offices across the nation, and the Office of the Surgeon General and the U.S. Public Health Service Commissioned Corps.

Are you still treating patients, or are you solely non-clinical?

Currently, my role is solely non-clinical.

How long have you been in your current acting deputy director role?

I have been in my role since April 2023.

How did you find your job? Did you apply or find it through a connection?

Prior to my current role, I was already working in federal policy and healthcare innovation with the Centers for Medicare and Medicaid Services (CMS), at the Center for Medicare and Medicaid Innovation. I was therefore familiar with the intricacies of how federal agencies operate and collaborate with the private sector as well as what kinds of opportunities might exist to transition between roles.

While at CMS, I had the opportunity to go on what is called a “detail assignment” where a federal employee from one agency can go on a temporary assignment to a new office or agency and engage with them. This allows skill building and a potential opportunity to build connections that lay the groundwork for a potential future permanent role in that new office.

Did you do anything special to your resume and cover letter to land the job as acting deputy director?

Part of the federal hiring process is to ensure your resume is tailored to the job opportunity. This ensures your skills, breadth of experience and knowledge are accurately and fully displayed for reviewing officials. I do this every time I apply for new roles and encourage others to do the same.

How have people reacted to you leaving patient care?

I have received overwhelmingly positive reactions from both clinical and non-clinical professionals. They are eager to discuss how I made the transition and how they can better approach a future transition for themselves, if or when it occurs.

What’s a typical day or week in the life like for you? What types of tasks and responsibilities fill your time?

A large part of my role is understanding current and emerging priorities for the Assistant Secretary for Health and helping to synergize forward momentum in these areas between federal agencies and external stakeholders, such as those in Congress, providers, patients, families, and different types of advocacy organizations.

What are some of the rewards of your acting deputy director role? What are the biggest challenges?

I feel such pride each and every day because I get the opportunity to build a healthier future for all Americans. Through my role here at the Office of the Assistant Secretary for Health, I get to promote and protect the health of all people and their communities. Public health creates that through line to allow organizational impact at a personal and population level.

Public health is very scientific, but it can also be very creative. This can be very challenging given the myriad of challenges facing our health system currently. I have a deep appreciation for the creativity required to truly shape meaningful policies and programs and engage different groups of people at different times.

Many times (it feels like most of the time!) the path forward is unclear and requires innovative thinking to be the change you want to see. But, this work is rewarding because success in public health policy allows me to blend science and creativity to adapt to the changes we feel, smell, and can almost touch every time we step outside our door.

How did your clinical background prepare you for this role? Which skills transferred?

All rehabilitation professionals are strong fits for non-clinical roles. It is my belief that those who have first-hand experience with how patients interface with the health system are best suited to drive real and lasting transformational change.

As an Occupational Therapy Practitioner (OTP), we are specialists at assessing the environments where individuals live, work, and play. My knowledge as an OTP makes me well-suited to highlight gaps that non-clinical policymakers may not fully recognize and structure opportunities for inclusive, whole-person policy development.

Ready to launch your own non-clinical career?

What type of person do you think would do well in your acting deputy director role?

For work across the policy space, one has to appreciate the big picture and have a desire to understand how pieces of our healthcare puzzle fit together. Healthcare is so complex because a patient’s journey requires a vast array of organizations with deeply specialized individuals leaning in at different times.

Curiosity to learn more than you already know and initiative to propose and push for changes that may not be realized immediately are deeply important to feeling successful and enjoying your work in healthcare and public health policy.

Do you work remotely or onsite?

Onsite.

Does your organization hire PT, OT, or SLP professionals into non-clinical roles? If so, what type of roles?

My organization is focused on public health and policy, so those are the skills and expertise required regardless of professional or clinical background.

Did you read any books, take any courses, or do anything special overall to get you where you are today?

I really like any of the books from Adam Grant and his philosophy on being the change you want to see.

What is a typical career path for someone in your acting deputy director role?

Most folks working within a health policy space have policy or program degrees, such as Master of Public Health (MPH), Master of Public Policy (MPP) and Master of Public Administration (MPA). But, particularly across healthcare, more and more clinically trained folks are engaged in the policymaking process and moving into policy determining roles.

There are clinically trained practitioners across every profession represented across HHS. As I note elsewhere in this interview, the key is weaving your professional narrative so that it is clear that your time spent in clinical settings also provided you the background and experience to appreciate policy and public health challenges.

What is next for you? What are your high-level career aspirations?

Such a fun question to answer!

I never know what the future holds, but currently I am pursuing a Doctorate in Public Health to deepen and solidify my public health acumen and understanding of public health theory of change.

What would you recommend to someone who is considering going into a role like yours? Do you have any special words of wisdom for the readers?

I would first recommend someone to think about their personal narrative and how they can weave their story to match the needs of the organization.

For me, in pursuing a leadership position in public health, I’ve always appreciated how individuals impact their lived environments and how a lived environment can impact the lives of those who live within them. My background is in human geography, the study of the intersection between people, place, and environment, and how these vary spatially across time and location.

Through the study of geography, I first developed an understanding of the primary drivers of change for individuals and populations, and how the lived environment impacts our lives and the opportunities afforded to us. Through this lens, I started to become more interested in the intersection between physical and behavioral health. I also wanted to learn about how one’s health may impact how an individual views their world and how their world views them.

In its essence, this is public health.

What career advice would you give yourself that you wish you had during school?

Don’t be afraid to ask for what you want. You will learn what is required more concretely by asking for something, which will inform your approach and move you on the pathway to achieving that career goal more effectively and efficiently.

I know it can be scary, but information is power, so go seek the information you need!

Do you have any special advice for others who want to follow in your footsteps?

I love this question. I hosted a conversation that matters with some federal colleagues at our recent AOTA INSPIRE annual conference in Orlando, Florida, focused on public health pathways for occupational therapy practitioners.

For more information about public health pathways, please visit: https://www.hhs.gov/careers/how-apply/how-apply-hhs-recent-graduates

There are two important considerations if you’re interested in working for HHS or any federal employer.

The first consideration is if you have the prerequisite experience that is being asked for. I frequently recommend students and new grads take time to gain experience through internships or part-time work opportunities in non-traditional/non-clinical settings, such as community-based organizations, county and state health departments, or private sector organizations to diversify their experience. Those further along in their careers (with less time to pursue internship or part-time work opportunities) can take advantage of volunteer opportunities with state and local governments or non-governmental organizations.

Any experience that enhances your understanding of the way in which federal, state, and local organizations work together to deliver services is helpful.

The second consideration is your professional narrative. Oftentimes, having many diverse professional experiences can seem like a lack of focus. I see it as a powerful tool to create your narrative for how you’ve deepened your understanding of healthcare delivery, client populations, and other considerations.

If you can artfully describe how your experiences furthered your personal and professional development, you can be competitive for federal service and other related professional opportunities, even if those you speak with aren’t familiar with occupational therapy.