Dr. Leana Wen, Day One: Charting Planned Parenthood’s Course for Protecting Women’s Health

Dr. Leana Wen

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Margaret Flin ter: Welcome to Conversations on Health Care with Mark Masselli and
Margaret Flinter , a show where we speak to the top thought leaders
in health innovation, health policy, care delivery , and the great minds
who are shaping the health c are of the future. This week , Mark and
Margaret speak with Dr. Leana Wen , newly appointed p resident of
the Planned Parenthood Federation of America, which seeks to
promote equal access to quality health care and protection of
women's reproductive rights in America. Dr. Wen is bringing her
considerable expertise a s Baltimore's Health Commissioner to
advance the public health mission at Planned Parenthood .

Lori Robertson also checks in , the managing editor of FactCheck.org ,
looks at misstatements spoken abou t health policy in the public
domain , separating the fake from the facts .

We end with a bright idea that ' s improving health and well - being in
everyday lives. If you have comments , please email us at
[email protected] m or find us on Facebook , or Twitter , iTunes , or
wherever you listen to p odcasts . You can also hear us by asking Alexa
to play the program , Conversations on Health Care .

Now , stay tuned for our interview with Dr. Leana Wen, president of
Planned Parenthoo d on Conversations on Health Care.

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Mark Masselli : We're speaking today with Dr. Leana Wen , newly appointed president
and CEO of Planned Parenthood Federation of America , dedicated to
protecting reproductive and other health rights nationwide . An
em ergency room physician and patient advocate , Dr. Wen recently
served as Baltimore ' s City Health Commissioner , where she earned
national acclaim for her public health interventions. A Rhodes Scholar ,
Dr. Wen earned her medical degree from Washington Univers ity
School of Medicine and completed her residency training at Brigham
and Women's/Mass General .

Dr. Wen , welcome back to Conversations on Health Care .

Dr. Leana Wen: Thank you so much.

Mark Masselli : You say you took this job because you see the threat t o women's
health a s one of the nation's greatest public health challenges . I'm
wondering if you could share with our listeners your vision for
Planned Parenthood under your leadership as well as some of your
concerns as you take on this new challenge .

Dr. Leana Wen: I am deeply honored to be serving in this role , leading Planned
Parenthood as we provide life saving , life changing health care to

Dr. Leana Wen

nearly 2.5 million patients every year. Th is job is deeply personal to
me. My mother was a patient of Planned Pare nthood when we first
immigrated to this country. She couldn't get health care anywhere
else . Planned Parenthood was there for her just like one in five
women in America.

I am deeply troubled by how women's health care is singled out,
stigmatized, and atta cked. We treat it differently than any other
aspect of health care. Take the [inaudible 00:02:43] that the Trump
Administration has proposed. It would mean that doctors and nurses
would be forced to censor what we can and cannot say to our
patients about r eproductive health care . Imagine the outrage of this
for any other aspect of medicine.

Doctors now can't tell our patients information about insulin, even if
they have diabetes that are coming in specifically asking for it . Yet we
silo out reproductive he alth care and women's health care, wh en
actually we in medicine know what's true, which is that reproductive
health care , women's health care is health care . Health care m ust be a
guaranteed human right . Fighting to protect that right and fighting to
provi de access to health care is the honor and privilege of a lifetime to
be able to do that now at Planned Parenthood .

Margaret Flinter: W ell, Dr. Wen , I want to maybe delve a little more deeply into some
of these enormous threats that are on the horizon to wo men's health,
what the appointment of Brett Kavanaugh to the Supreme Court will
mean for women's health , and large swaths of the country where
safety net clinics ha ve been forced to close , putting so many women
at risk . Share with us, if you can, some of t he guiding elements of your
plan for confro nting these enormous challenges .

Dr. Leana Wen: I'm learning more about the organization now and seeing for myself,
just how committed the exceptional physicians, clinicians, staff are
who work at our over 600 hea lth centers around the country. We
provide primary health care . We provide reproductive health care for
many of our patients. We are their only source of health care . We
have seen what happens when safety net clinics close around the
country. We're talking about women going without access to breast
and cervical cancer screening.

Planned Parenthood does more to prevent unintended pregnancy
every year than any other organization . We're also seeing what's at
stake with this Supreme Court and the relentless at tacks on women's
health. The re are 15 cases on reproductive rights that are just one
step away from the Supreme Court, which means that we are facing a
real probability that Roe v . Wade could be overturned or further
eroded in the next year . That means tha t 25 million women could be
living in States with no access to reproductive health care and
abortion services.

Dr. Leana Wen

How would we tolerate this for any other aspect of medicine? We
have 400 laws that were passed in the last seven years that directly
restrict wo men's access to reproductive health care , not based on
science. They are politicians telling us what we can and cannot do, like
a forced ultrasound , laws like a 72 - hour waiting period, which we do
not apply for any other safe legal medical procedure . The re a re also
laws that have forced so many clinics to close that in several states.

There's only one provider left in the entire State s and women have to
drive hundreds of miles to access life saving health care . We will
continue to refine and implement our contingency plan for health
care access because that's what Planned Parenthood has always done
and that's what we will continue to do.

Mark Masselli : Dr. Wen , your life experiences bring so much to the job, both as a
young immigrant, a former Planned Paren thood patient yourself, a
physician, City Health Commissioner in Baltimore, confronting such
things as the opioid crisis, gun violence, infant mortality , and y ou
really have incredible consensus building strategy. I'm wondering how
you plan to leverage the se skills of building consensus to expand the
mission at Planned Parenthood .

Dr. Leana Wen: I've been privileged in Baltimore . I'm glad to have led efforts at our
city , like Vision for Baltimore, t ogether with partners , including Johns
Hopkins and Warby Pa rker , the g lasses provider , t o get glasses to
every child who needs them in Baltimore. I also led a collaborative,
B'more for Healthy Babies program, dropping infant mortality by
almost 40 % in seven years , and cutting the disparity between black
and white infant mortality by more than 50 % in that period . Our work
around the opioid epidemic also involved many partners around a
North Star [ PH 00:07:03] .

No matter what political backgrounds we come from, we can focus on
what's most important, the lives of wom en, which equals the lives of
families , and the statistics around health outcomes that frankly are
poor. The U.S. is the only industrialized country where total maternal
mortality has increased, not decreased, but increased over the last 20,
25 years here . African - American women have a three to four fold
higher mortality for maternal mortality and a 40 % chance of dying
from breast cancer than white women . As a physician, as a public
health leader, I am committed to reducing these disparities . That's
somethi ng I hope that we as a country can get behind.

Margaret Flinter: Well, in this climate we have with so much political wrangling going
on , I think it's critical that we remind our listeners that abortion
actually represents only about 3 % of the overall heal th services
provided by Planned Parenthood . You really are the dominant
women's health care provider for primary and preventive health in so
many communities .

Dr. Leana Wen

The other thing I think that gets lost is what a significant trend we've
seen in reduced unplann ed pregnancies. Can you just speak to how
the important services provided by your organization are actually
helping to reduce unplanned pregnancies?

Dr. Leana Wen: The data show that we are at record lows for teen pregnancies, for
unintended pregnancies . I t's no coincidence that we also had the
Affordable Care Act that gave 55 million women the ability to have no
c o - pay b irth control . In Baltimore , as a result of our expanding sex
education , so that it's comprehensive in middle schools and high
schools and providin g services, we had a 61 % drop in teen
pregnancies in the last 15 years.

That's what Planned Parenthood does around the country. That's
what we do together with our medical and public health partners .
We're actually seeing these games that we've ma de being rolled back .
In Baltimore , the Trump Administration cut our Teen Pregnancy
Prevention funds . We sued them and we got our funding restored,
which allows 20,000 of our young people to once again receive
comprehensive sex education .

Less than 24 hou rs after the midterm elections , President Trump
issued a new rule that would allow employers to deny women access
to birth control . I just cannot believe that it's 2018 and we're still
debating birth control. I also think it's hypocritical if the goal is t o
reduce unintended pregnancies and the need for abortions that we
should be investing in what the data show us to work, which is birth
control, which is comprehensive sex education , and I think it's
important to talk about abortion in that context. One in four women
will have an abortion in our lifetimes in America . It is part of the full
spectrum of reproductive health care .

Look, I've treated women who've been in all types of circumstances,
women who got pregnant because their birth control failed , w ome n
who had much desire d pregnancies, but then something went wrong.
I treated a patient who was diagnosed with metastatic cancer while
she was pregnant , and she needed an abortion to save her life. These
are the very real, very personal circumstances that w e find our
patients in . My job as a physician, as a provider , isn't to judge my
patien ts . It's to give them medically accurate information and
empower them to make the best decisions for themselves. I trust my
patients. I trust women.

Mark Masselli : We're speaking today with Dr. Leana Wen , newly appointed president
and CEO of Planned Parenthood Federation of America. Dr . Wen ,
we've had the great privilege of having Cecile Richards on the show
before , your predecessor . She was quite vocal about bringing the
st
organization into the 21 century . She launched a number of mobile -
enabled digital programs that have had a huge impact on expanding

Dr. Leana Wen

the organization's ability to reach a larger number of people . I wonder
if you could talk about that modernization of Plan ned Parenthood 's
approach and how telemedicine and other technology interventions
will allow yo u to serve a broader population .

Dr. Leana Wen: We have not talked about another core aspect of what Planned
Parenthood does. We are the largest provider of educ ation for sexual
reproductive health in this country. We have millions of visitors to our
website every month to learn about these critical topics . We also
realize another core tenet of public health, which is that we should
meet people where they are . Mee ting people where they are include s
telemedicine. It includes one of our programs that does chat text , that
people can text us and ask us questions , and we will respond in real
time .

Part of meeting people where they are is realizing too that it's not
onl y through technology, that the personal outreach is also important
through partnerships. We partner with school districts around the
country to deliver sex education . We also reach people where they
are through outreach in communities. We have a promotor e s
program with community health outreach workers , who are doing
sexual reproductive health education and health promotion in
barbershops, in migrant farms , and really where it is the people are .
I'm excited about continuing to emphasize this core public hea lth
crucible as I start in my work here at Planned Parenthood .

Margaret Flinter: Well, Dr. Wen , looking at the challenges that were on deck when you
took on the role of Baltimore's Health Commissioner and now in your
role at Planned Parenthood , but , I think it's very instructive for our
listeners to hear a little more about that work. You h ad the death toll
from the opioid crisis going up , j ust a deadly epidemic of gun violence
going on in the community . You implemented some really effective
interventions on all these fronts. Talk to our listeners about that ,
particularly maybe about the wor k that you did in the opioid crisis,
but a lso w hat you did around gun violence .

Dr. Leana Wen: Well, around the opioid epidemic , w hen I first came into my role in
Baltimore, we were seeing an escalating number of people dying . I
wanted to do whatever I cou ld as soon as I could, which i s another
core principle for me, coming from the emergency department . You
always do what you can now. You never say, let somebody else do
that first . You do whatever you can with what you have . Working in
the ED , I know about using naloxone , or Narcan , the opioid antidote.
I've seen how someone who is overdosing and about t o die will be
walking and talking within seconds to minutes of getting this antidote .

I issued a blanket prescription to every single one of our 620,000
re sidents in Baltimore . As a result of this blanket prescription, we
were able to have everyday residents in our city save the lives of

Dr. Leana Wen

nearly 3 , 000 family members, friends , and fellow community
members.

We also mobilized and worked with all of our acute ca re hospitals in
Baltimore because we believe that it's up to all of us to be treating
addiction as a disease that it is. We're the first major city to have
gotten together all of our hospitals to now be in level 1 , level 2 , level
3 . Then we also started a 24 /7 ER for addiction of mental health ,
called a stabilization center. I'm very proud of the work that we did in
collaboration , d o ing what we can now , going to where people are .

You mentioned about gun violence. We also focused on treating
violence as the public health crisis that it is. There is no question for
me, after treating victims of gun violence, after treating people who
died from gunshot wounds, that gun violence is absolutely a health
issue . How could it not be a health issue ? We also look at t he research
that shows that violence is a contagious disease. It spreads from
person to person, just like the flu. It's something that is able to be
treated and able to be pre v ented .

I led a program in Baltimore , called Safe Streets , where we hired
indivi duals from the communities that they serve. Many of these
individuals are recently released from incarceration . These individuals
walk the streets and they mediate conflict, stopping gun violence
before it happens . In one year , they mediated nearly 1,000 c onflicts,
80 % of which were found to later to be at likely or very likely to
escalate into gun violence and gun death. We need to be looking at
public health solutions to many of the most pressing problems facing
our society, including gun violence.

Mark M asselli : Well, all of those were inspired interventions in public health and we
applaud you for that. I think most of our listeners know the role that
Planned Parenthood plays in reproductive care and as well primary
care . Not sure they understand the role that you play in educating the
next generation of health providers . I wonder if you could talk a little
bit about the role Planned Parenthood has played historically in
making sure that next generation of health providers are fully
equipped and knowledgea ble to prov ide care throughout the country .

Dr. Leana Wen: We are proud to provide exceptional , high quality , judgment - free
health care to all our patients in our over 600 health centers around
the country. We also have traditionally and continue to partne r with
universities , with residency programs , to train the next generation of
OBs , of family physicians, and really all doctors who should be able to
treat reproductive health care .

It's long past time that we understand that we need to treat a person
as the whole patient . We're proud to be educating the next
generation on sexual reproductive health . At the same time, we also

Dr. Leana Wen

are expanding our services. Under my leadership , we will continue to
be not only providing health care and fighting to protect acces s to
health care , but my vision also is to expand our reach, expand our
services.

The patients who come to us don't just have one need . They may
come to us for S T I testing. They may come to us for birth control . They
may also have unresolved and untreated mental health issues. They
may also have addiction. They may also be in need of primary care
services. Maybe they also have untreated hypertension. Maybe they
also need to have their blood glucose check ed . We should be able to
provide the full spectrum of all health care and our health centers .
Reproductive health care should be provided in all medical settings
because reproductive health care and women's health care is health
care .

Margaret Flinter: We've been speaking today with Dr Lean a Wen , president a nd CEO of
the Planned Parenthood Federation of America, an organization that's
dedicated to protecting reproductive and other health rights. You can
learn more about their work by going to their website,
plannedparenthood.org , or follow them on Twitter @PP FA . You can
follow Dr . Wen ' s work on Twitter @DrLeanaWen , and that's L - E - A - N -
A .

Dr. Wen , t hank you so much for your powerful advocacy for
population health, for women's health , and women's reproductive
health rights . Thank you so much for joining us on Co nversations on
Health Care today.

Dr. Leana Wen: Thank you.

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Mark Masselli : At Conversations on Health Care , w e want our audience to be truly in
the know when it comes to the facts about health care reform and
policy. Lori Robertson is an award - winn ing journalist and managing
editor of FactCheck.org , a nonpartisan , nonprofit consumer advocate
for voters that aim to reduce the level of deception in U.S. politics.

L ori , what have you got for us this week ?

Lori Robertson: In late October , h our s after t he mass murder at a synagogue in
Pittsburgh, President Donald Trump told his supporters, " We have to
bring back the death penalty . ” The federal government in 31 states
already have the death penalty , but there hasn't been a federal
execution in 15 years , a nd state executions have sharply declined in
recent years. The federal government reinstated the death penalty in
1988 . There are currently more than 60 prisoners on federal death
row according to the Death Penalty Information Center .

Dr. Leana Wen

However, there have been only three execution s since the federal
death penalty was reinstated . The last one occurred in 2003. As for
state executions, there has been a steady decline in recent years.
Eight states carried out 23 executions . That was half the number of
seven ye ars ago and t he second lowest total since 1991. So far this
year , there have been 19 execution s .

Robert Dunham, executive director of the center , said there are
multiple reasons for the decline, including the inability of state
government to obtain the dr ugs they need for lethal injection.

The National Conference of State Legislatures says lethal injection is
the primary method used in states that have the death penalty . In
2008 , the S upreme Court ruled that a three - drug lethal injection
doesn't violate t he constitution 's ban on cruel and unusual
punishment. Specifically, the High Court approved a three - drug
combination that includes a sedative , a muscle relax er that induces
paralysis and stop s respiration , and a third drug that causes cardiac
arrest . Drug manufacturers since then have refused to sell their drugs
for execution s. States have had difficulty in obtaining the right
combination of drugs.

Hospira Inc. , t he sole U.S. manufacturer of one of the drugs, sodium
thiopental, suspended production of the drug in 2009 due to
difficulties procuring its active ingredient , and t hen two years later ,
stopped production permanently after moving its manufacturing to
Italy. In 2011, the European Union also banned exports of the drug .
Arizona, California, and Tenne ssee turn ed to imported sodium
thiopental from other foreign sources until death row inmates in
those three states successfully sued to force the FDA to prevent the
importation of a drug that was not FDA approved.

That's my fact check for this week. I'm L ori Robertson, managing
editor of FactCheck.org .

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Margaret Flinter: FactCheck.org is committed to factual accuracy from the country's
major political players and is a project of the Annenberg Public Policy
Center at the University of Pennsylvania . I f you have a fact that you'd
like checked, email us at chcradio.com . We 'll have FactCheck.org ' s
Lori Robertson check it out for you here on Conversations on Health
Care .

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Margaret Flinter: Each week , Convers ations highlights a bright idea about how to make
wellness a part of our c ommunities and everyday lives. When Chef
Karl Guggenmos grew up as a kid in postwar Germany, he lived on a
diet of organic and locally grown foods. Now , he's the dean of the

Dr. Leana Wen

culinary arts program at Johnson & Wales University in Rhode Island .
He realized that he has responsibility to teach the next generation of
chefs how vital, natural , and simple ingredients are not just to
creating good food, but to the health of the population as well.

He watched the obesity epidemic take hold in this country and
decided to use his platform to create a new approach to chef training.
He teamed up with a professor of medicine at Tulane University
Medical School in New Orleans , and together they crea ted what they
believe is the first course in culinary medicine in the United States,
teaching chefs and fourth year medical students how to understand
the synergy between healthy eating, good food , and good health.

Karl Guggenmos : We created this program w here our students are actually going to
Tulane Medical School for an internship , and they work side by side
with medical students and physicians working in the community,
do ing research, using an evidence - based approach to this whole idea
of culinary medic ine.

Margaret Flinter: In addition to learning knife skills, sauté , and poaching techniques ,
f ourth year medical students are given a lesson in food pairings,
learning which foods are most poised to foster good health and to
combat obesity in their future patients' lives.

Karl Guggenmos : The medical students at the Center for Culinary Medicine , they hav e
their own coursework that we helped them develop . They identify
ingredients as to their relationship to health. They then start basic
introduction to cooki ng from knife skills to how to sauté , how to
poach, how to roast . Then they do recipe conversions . Then they have
to do research . Our students are there. They're engaged working side
by side with the medical students, exchanging information and
techniques from each other. It's really unique . It's one of its kind . I
think it's the first around the world . We're getting more and more
traction about this .

Margaret Flinter: He strongly believes in the idea that chefs will be the pharmacist s of
the future . A dean of a reputable culinary program , teaming up with a
medical school to train future doctors , armed to assist their patients
in healthier eating, n ow that's a bright idea.

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Mark Masselli: You've been listening to Conversations on Health Care. I'm Mark
Masselli .

Margaret Flinter: I ' m Margaret Flinter.

Mark Masselli: Peace and h ealth .

Margaret Flinter : Conversations on Health Care is recorded at WESU at Wesleyan

Dr. Leana Wen

University , streaming live at chcradio.com , iTunes , or wherever you
listen to podcasts. If you have comments , please email us at
[email protected] or find us on Facebook , or T witter. We love
hearing from you. This show is brought to you by the Community
Health Cente r .

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