Former Baltimore Health Commissioner, Dr. Leana Wen speaks at the Johns Hopkins Bloomberg School of Public Health.

Dr. Leana Wen said that when Donald Trump was elected president in 2016, she fretted about what it meant for women’s access to reproductive health care.

Wen, then Baltimore’s health commissioner, said this led her to jump at the chance to go to work for Planned Parenthood. But after a rocky nine months heading the organization, she was ousted by the group over policy differences. It was a rare setback for an immigrant of limited means who went to college at 13 and became a Rhodes scholar and emergency room doctor before heading to Baltimore.

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Wen referenced the firing, covered by multiple national news outlets, in a talk Tuesday at Johns Hopkins’ Bloomberg School of Public Health about leadership in public health settings. The public comments were her first since a spat over her separation agreement with the national group that she said also contained a secondary confidentiality agreement she refused to sign. They reached an agreement last week.

Speaking out about her experiences, she said, is integral to her public health leadership. She told the students on hand at Hopkins that they should use evidence for context, but personal stories for real impact. In this case the story was her own.

“There are a lot of ways to approach a problem and good people can disagree,” she said about her differences with the board of Planned Parenthood.

She said she saw reproductive rights as a health care issue while the group wanted to focus on abortion politics.

Still, she said she learned about leadership, and its limitations, and does not regret the move.

“It was a profound privilege to represent the organization,” Wen said. “We have seasons in our careers, and we have to be OK with the choices we make in that season.”

She described how meaningful it was to visit a Planned Parenthood clinic where she received care when she was younger as the group’s president.

But Wen also spoke of the costs of outspoken leadership. She said she received threats to herself and her young son, who she had spent so many days at a time away from that he stopped looking to her for parental comfort.

Wen shared the stage with Dr. Joshua Sharfstein, vice dean for public health practice and community engagement in the Bloomberg school and a former Baltimore health commissioner, state health secretary and deputy commissioner at the U.S. Food and Drug Administration.

He gave his own take on handling leadership. With a board or a mayor, governor or president to answer to, you can’t always say everything you want. Change sometimes has to be incremental, he said.

Figuring out how to make the most impact within the confines of a public health organization or agency is a kind of “puzzle I like to solve,” Sharfstein said.

He and Wen agreed that speaking up was essential.

Wen said public health advocacy also has unique challenges because it often involves talking up the importance of “what didn’t happen”: Those who did not get pregnant and did not have an abortion, those children who did not get lead poisoning because the pipes and paint were not contaminated, or those who did not get shot because of violence prevention programs.

Wen plans to keep pushing the importance of public health. Her next position is teaching at George Washington University’s School of Public Health. She also is expecting a daughter in March.

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