Size says a nurse is exactly what HRSA needs. "Nurses, especially senior nurses, think very systemically. They are probably the one profession that is trained intuitively to break through silos," he says. "She will very much be working on how to help clinics continue to fulfill their mission, and also on how they relate to the rest of the system and how we maximize those relationships."
Wakefield made it clear that she does not regard herself as merely a functionary for the Obama administration. "Front and center I work for the president and I'll be taking my directions from his healthcare team. It's there that I'll be getting much direction," she says. "But in addition, I was brought to this by some of the expertise that I have. This is really about working for, on behalf of, and in sync with the vision that will be articulated by the administration. I have every intention of complementing that with the expertise that I will bring not just managing an agency but knowing something about many of the programs that are operationalized through that agency."
Wakefield says she expects her priorities at HRSA will include ensuring that the $2.5 billion in stimulus money that flows through HRSA goes toward its intended targets, which are improving the healthcare infrastructure and training healthcare professionals. She says she also expects to examine HRSA programs and their relationship with the health reform proposals that President Obama is bringing forward.
Wakefield says HRSA's role has become more critical with the collapse of the economy as more people lose their jobs and their health insurance. She says HRSA can greatly impact rural healthcare by promoting programs like the National Health Service Corps, which places physicians and other healthcare providers in underserved rural and urban areas.
She says she anticipates looking at the Office of Rural Health Policy, which is located in HRSA, to promote programs that encourage collaboration between rural and urban hospitals. "There are different program levers that can be pulled to try to meet the simple workforce needs and help support safety net infrastructure in urban and rural underserved areas," she says.
Wakefield was asked what message the Obama administration was sending to rural healthcare advocates and observers by picking her.
"What this communicates to me is that rural is not left behind. Rural is part and parcel of the focus of programs that are so important to individuals and programs that reach directly into the heart of communities," she says. "They are saying rural is part of that too."