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Healing Path

How a midcareer pivot led alumnus Norman Oliver to become Virginia's health commissioner

PHOTO: Courtesy of the Virginia Department of Health

During a listening tour last year, Viriginia's state health commissioner, M. Norman Oliver, MD, visited Eastern Virginia Medical School. Oliver met with community members and local leaders during the tour about issues or challenges that create barriers to improving the health of their communities.

M. Norman Oliver was a managing editor for several Harcourt Brace Jovanovich medical journals when he had a life-changing realization: He wanted to do what the physicians on his editorial board were doing.

Their work involved "far more than simply clinical care," said Oliver, MD (GRS '92, anthropology; MED '94). "It was having relationships with multiple generations of patients' families and connecting to the community that these families belonged to."

Oliver was nearly 38 years old and lacked a college degree. But he was undaunted in his pursuit of a medical career.

He spent two years working by day, taking undergraduate classes at night and doing homework until late into the evening. His wife, Susan M. Jacobson, took on more care for their two children and household responsibilities.

A number of medical schools accepted him. Oliver, who already was living in Cleveland, chose Case Western Reserve, in part, because he felt comfortable there as an older student. The School of Medicine "prided itself on accepting ‘bent arrows,' as they used to say," Oliver said, referring to a school term describing someone who took a different path before deciding to be a doctor.

Even as he pursued his MD, Oliver earned a master's in medical anthropology, fascinated by how culture and social conditions affect health and wellness.

After completing a residency program, Oliver moved with his family to a remote Alaskan fishing village, where the scope of his work widened by necessity. "I was able to do really broad-spectrum, comprehensive care in a way that is hard to do in many places within the continental [United States]," Oliver said. He also saw the health impacts of social problems.

"For the adult population there, the No. 1 issue was accidents and injuries—and almost all of that was related to alcohol abuse."

Pulled back to the contiguous U.S. by a desire to be closer to family and a job offer, Oliver began a 21-year career on the faculty at the University of Virginia. In 2011, he became chair of the school's family medicine department. The new role gave him the opportunity to have more impact by broadening his focus from individual patients.

"I became really interested in … thinking about the community in which they live and how working with that community could improve the health and wellbeing of all those people," he said.

Oliver saw a similar opportunity when he took the job of deputy commissioner for population health for the Virginia Department of Health in 2017, which he held before being named state health commissioner last year.

Oliver began his stint as health commissioner with a listening tour of Virginia, meeting people who spoke about a wide range of issues: the opioid epidemic, barriers to health care access, and shortages in behavioral care treatments.

Solutions to those problems couldn't be handled by one state office, Oliver said. Such broad, deep-rooted social problems required broad solutions—and that meant building collaborative approaches. For example, he helped launch Partnering for a Healthy Virginia, an initiative that pairs his office with the state hospital association as well as local banks, big regional employers and nonprofits to tackle endemic public health issues. First up: a one-year campaign to combat diabetes and cardiovascular disease.

How does he measure impact? Improvements in measures such as the state rates for diabetes and addiction—and new laws, including one passed in 2018 that raised Virginia's smoking age to 21. His office had helped push for the law.

"If I look at the health outcomes and see improvement and I can look at state policies and make some important changes there," he said, "I will feel good about my tenure as a state health official."

— Dan Morrell