Back when Mary Wakefield was starting her career, she considered the two fields that seemed to offer opportunities for women at the time: nursing or teaching. Wakefield chose nursing, and that decision has since taken her to the halls of Congress, back home to North Dakota and now to lead one of the most important healthcare agencies in the nation.
On Feb. 20, Wakefield, 54, was appointed administrator of the Health Resources and Services Administration, or HRSA, the federal agency overseeing healthcare delivery to the growing ranks of America's uninsured and underserved.
Scan our alphabetical list of this year's Top 25 Women in Healthcare and a pattern emerges: Most of the women on the list are playing key roles in shaping the healthcare reform in Washington. Eight percent of the 25 are leading interest groups such Nancy Nielsen of the American Medical Association, Karen Ignagni of America's Health Insurance Plans, Mary Grealy of the Healthcare Leadership Council and Mary Kay Henry of the Service Employees International Union.
Twelve percent, like Wakefield, Nancy-Ann DeParle and Kathleen Sebelius, have accepted—or been nominated for—powerful positions within the Obama administration. Another 8% are overseeing large policy and grant-making organizations, such as Risa Lavizzo-Mourey of the Robert Wood Johnson Foundation and Karen Davis of the Commonwealth Fund. Twenty percent work in academic research, 32% are running major hospital systems, and 8% lead health insurance companies while lending their expertise to the wider debate on healthcare reform.
More than ever, women are in seats of power in healthcare, and these women in particular are working to shape what our healthcare system will look like in years to come. “Healthcare is a big mess, and if I can make a contribution, it's important for me to be here,” Wakefield says.
Wakefield, 54, grew up in Devils Lake, N.D., and spent part of her education and career in Texas, Virginia and Washington. She served as chief of staff to Sen. Kent Conrad (D-N.D.), and as legislative assistant and chief of staff to Sen. Quentin Burdick (D-N.D.) “From my perspective, Congress was a great place to apply that on-the-ground training I got through nursing,” she says. She went on to become director of the Center for Health Policy Research and Ethics at George Mason University. Eight years ago, she returned home to direct the Center for Rural Health at the University of North Dakota, serving as a national expert on rural health issues, quality and patient safety, Medicare payment and healthcare workforce issues.
“There came a point when I felt what I was doing in Virginia was a job a lot of people could do,” Wakefield says. “I felt it was time to go back home and help people who had helped me.”
But when she got the invitation back to Washington to join the Obama administration, she couldn't say no. “I think HRSA has its finger on the pulse of a number of key issues,” Wakefield says. “Its programs are pivotal to ensuring access to quality healthcare for vulnerable populations.”
And the economic crisis has made the HRSA's programs ever more important. The HRSA is tasked with administering $2.5 billion allocated in the American Recovery and Reinvestment Act of 2009 to invest in healthcare infrastructure, including $2 billion toward HRSA's community health centers and $500 million to train and deploy healthcare workers.
While problems of access to insurance and providers are more challenging in rural settings, Wakefield says she believes that we can apply a lot of lessons learned in rural health to the greater issues facing America—access, affordability and quality.