Interview with Julia Adler-Milstein

Do you have siblings? Please share a family anecdote that illustrates the connectivity of your family and a particularly happy time in your childhood.

I have a younger sister who lives in The City. She is a labor rights activist and is someone who I deeply admire and who makes a difference in peoples' lives. She was in college at Brown, in Providence, Rhode Island, when I lived back East and that's where we became friends, as adults. She lived in the Dominican Republic for many years, set up fair trade factories, and then moved to San Francisco about five years ago. When I think about my family growing up, it would be the many times we spent at our home in Sonoma; it's the place itself that is special; around the dinner table as the sun set, playing board games, and just spending meaningful family time together. We were at the house the night that the fires started in Sonoma. We had to evacuate, and the house did burn down, which was very traumatic. It was a very sentimental loss, unexpected and scary.

Do you recall your grandparents? Have you ever been told that you are like any of them?

I knew my father's parents much better than my mother's parents. I have vague memories of my maternal grandfather and my grandmother was, for a long time, in the Jewish Home for the Aged where she had Alzheimer's. It was odd to return there recently, where I had memories as a kid, because I was conducting an interview for a research project. My paternal grandmother is 92 years old and she is the most generous person you would ever meet. She would literally give you the sweater off her back if you compliment it. I am nowhere near as generous as she but I hope I share some of what makes her special.

Who do you credit for your vitality and dynamic outlook? By what standards or measurements do you judge yourself?

Definitely my parents. They were incredibly supportive at every turn when I was growing up and into adulthood. They never pushed what they wanted and, although they probably had lots of opinions, they let me tread my own path. They were not helicopter parents. They get 100% of the credit! In the context of measures, I think of my sister because she is meaningfully improving the quality of lives on a day-to-day basis, fighting for better working conditions. She makes me continually push myself to ask, "Am I really helping people in general, particularly the vulnerable or those who have the least ability to help themselves?" Her example pushes me to question my efforts, particularly in research, when it can be really hard to feel like you are helping people or understand the impact of your work. It is something I struggle with in terms of the questions I choose to study.

Your professional voice is in print, on the web, radio, Twitter, and YouTube. How do you manage your multifaceted tools and your public profile? 

It's hard. I honestly feel that I don't do a great job. You can be online all the time and constantly put your thoughts and ideas out there, but my personality is a bit reserved and I want to think through what I say and how I write about issues so I struggle with the media that favors people who can just get it out there. I should probably push myself to carve out time for blog posts and be more engaged on Twitter because that is how people are having impact but, because it doesn't come naturally to me, I stick to writing papers and doing interviews and having conversations. I could maybe have bigger impact if I would push myself out of my comfort zone.

Has anyone ever told you about a habit you didn't realize you had? What recent self-realization surprised you?

Professionally, I have a deep insecurity that there may be things that I could do better or that could be improved and that maybe people wouldn't tell me. I don’t get a lot of feedback and I worry that people may not be comfortable telling me how I could improve. On a personal level, I multitask too much. I am often distracted from things I care about because there are too many other things on my mind. I am very guilty of that, even when I know better. It's driven by my desire to be as productive as I can be.

When do you get the most accomplished?

Flying on airplanes. Traveling is the only time I get uninterrupted time and I get excited about getting on a flight and having five hours to work.

Do you ever "waste" time and how? Is there a completely mundane thing that you get lost in doing?

Having just moved, there are a million things to do: organizing my closet or doing things around the house. For me, exercise is my respite, swimming and hiking on Sundays with just my husband, just the two of us. That's when I feel the most clearheaded, most able to take off my blinders, see what's important, and wrestle with ideas. I also just get a lot of satisfaction from doing the little mundane things, the list of work things and personal things, and I get great satisfaction from crossing things off of lists.

How do you encourage people to see the grays in life instead of in black and white?

In my work, the grays are essential because there are very few things in health care that are black and white. I feel all the time that I am pushing people to see the gray because it is the reality, and I feel that that is one of the things at which I've gotten better over time. I've acquired a skill set in explaining complex concepts in ways that people understand so they can grasp the nuance and complexity of my research. In my personal life, it's something you have to get better at as your kids get older. My daughter is six and she still largely sees things in black and white. She is wrestling with the concept of poverty, of people who are poor or homeless; I have to acknowledge and try to help her while being aware of how much gray she is ready for.

Much in health care has changed since, in 2015, you presented to the U.S. Senate Committee on Health, Education, Labor and Pensions about Health IT Transformation. How do you keep the message and its urgency fresh in a changed climate?

If your goal is to have impact, then you have to learn how to have impact under leadership that may have different priorities. The change in administration has been a fun challenge: how do I take my work, craft it to fit a different administration and still have positive impact in areas that I perceive as important? There is a concept called "policy windows" where you could work on an issue for your whole career when a very brief window of opportunity randomly opens where you have a moment to have impact. The policy windows that are open today are different than the policy windows that existed under previous administrations. You have to communicate in ways that are specific enough to lead to action, but not abstract in ways that the message could be lost; even if I do not change someone's thinking, I might shift it a few degrees. It is invigorating and fun to try to have my efforts make a statement that is supported by research.

Do you have an alter ego and what is she like?

I don't think I have an alter ego. I am someone who puts myself "out there," and that is likely how I come across. My true self is pretty shy and finds social interaction exhausting, but when I am out in the world I find people fascinating and stimulating. It is two very different ways of being and they both feel right. One of these days I should take the Meyers-Briggs again! I get all the stimulation I need at work, so at home we don't do much entertaining and I am content with being with my husband and daughter.

Thank you, Julia.

- by Oralia Schatzman

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