After Service as Chief Medical Officer, She Made Domestic Violence a Priority

Written for the Daily Record –

Dr. Joann Schaefer

Before the O.J. Simpson case brought it to the national spotlight, domestic violence was a topic seldom spoken of outside the home. Joann Schaefer, M.D., ABFP, has made it her personal mission to spread awareness and prevention of domestic abuse.
Not only does Schaefer have a passion for public health, she has a personal connection to the work she has done to help victims of domestic violence.
During her first year in medical school, Schaefer’s best friend lost her life due to domestic violence. Her friend had gotten out of an abusive marriage, only to be killed by her ex-husband three weeks later.
Looking back, she said, “Her children are my godchildren, so it’s been a big journey. Right after her death, it made me try to understand what was happening in domestic violence. There was a lot being done, but it wasn’t being talked about on the national scene, and when I was in medical school I had about a five-minute education on it. That was kind of infuriating to me.” In those days, she said, medical schools paid scant attention to domestic violence.
Schaefer recounted the number of times her friend had visited the emergency room over the course of several pregnancies, presenting with injuries that “doctors didn’t seem to know how to handle or what to do.” In one episode, her friend explained to the physician examining her that her two black eyes and a fractured eye socket were the result of falling down a flight of stairs.
This unwillingness to talk about their situation is common in many victims of domestic abuse. Physicians are now being trained to delve deeper into circumstances when injuries and stories do not add up. Much of this training is thanks to Schaefer. After her friend’s death, Schaefer set out on a mission to bring education on screening and diagnosis of domestic violence patients to doctors, nurses and anyone working in the medical field. During her time working with Creighton Medical School, she changed the curriculum dramatically.
“We got the curriculum changed from about five minutes on domestic violence to over sixteen hours at both medical schools here [in Nebraska], as well as nursing schools. That’s why you are asked about your safety now when you go into an emergency room,” said Schaefer.
Her curriculum is particularly “hands-on” and includes actual ‘911’ tapes, forensic photographs, news clips and, at times, survivors. “The whole point,” Schaefer said, “is to grab students’ attention and use an actual clinical case to present all of the key teaching points.”
Partnering with local organizations such as the Women’s Center for Advancement, Schaefer stresses providing nonjudgmental support to those that may be living in a dangerous situation.
“One of my fervent interests is educating medical students, physicians and the public on the warning signs of domestic violence,” said Schaefer. “You never know a [person’s] safety situation better than he or she does. It’s important to not judge, but to be supportive and ask questions.”
Medical Resume´
One of the reasons Schaefer was in a position to act on her beliefs was due to her medical resume in Nebraska.
Originally from California, Schaefer earned her undergraduate degree in biology and public health from California State University-Fullerton, then graduated from Creighton Medical School, “fell in love with Nebraska and stayed.” She has since been recognized by both Creighton University Medical School and California State University-Fullerton for her service and as a distinguished alumna.
Given her interest in public health and safety, Schaefer’s career path has seemed perfectly logical, leading her to positions of ever-increasing responsibility. But she stressed it was never planned. “I never sought these positions,” she said. “None of them were ever on my career path. I was just focused on doing my job really well at the time, pushing for things to be better and trying to be the best person I can be, knowing you have to have a lot of self-reflection and be willing to get better.”
When tapped to serve the state after a number of years in private practice and teaching at Creighton’s medical school, she agreed to serve as deputy director if this would be a half-time position to allow her to continue her very active family medicine practice, including obstetrics; her tenured position as associate professor in Creighton University Medical Center’s Department of Family Practice; and her ongoing, nationally recognized efforts to curb domestic violence.
Schaefer moved from deputy medical officer in 2002 to chief medical officer for the State of Nebraska in 2005. She was the first woman in Nebraska’s history to hold that post. She also served in a dual role as director of the Division of Public Health for the Nebraska Department of Health and Human Services and earned several awards for her work.
As such, Schaefer was appointed by then-Governor Johanns to devise a plan for Nebraska to adopt in dealing with cases of domestic violence and the effects on children’s lives.
She was honored in 2003 by the National Institutes of Health and Human Services’ National Library of Medicine as a “Changing the Face of Medicine: Local Legend.” That honor, whose recipients are nominated by members of Congress, was in response to her being a “crusader against domestic violence.”
Congressman Lee Terry’s nomination letter said, “she has truly changed the face of medicine in Nebraska.”
Leaving her state post in 2013, she joined Blue Cross and Blue Shield. She quickly moved up the ladder there, and now serves as executive vice president, Health Delivery Engagement and chief medical officer. She is responsible for the company’s Risk Adjustment, Health Network Services, Case Management, Reimbursement Strategy, Utilization, Quality, Pharmacy, Medical Policy and Wellness Areas.
Other things you might want to know about this accomplished professional. The six-foot-tall physician is married to Phil Haines, a retired Marine Corps gunnery sergeant, and together they have raised his two young daughters. She was diagnosed as a young woman with a genetic liver disease that would one day require a transplant. While serving as chief medical officer, she received that life-saving transplant with a partial liver donated by a friend and fellow doctor, Gary Gorby, now chief of the Department of Medicine, Nebraska-Western Iowa VA Healthcare System.
She believes both she and her husband – who underwent quadruple bypass heart surgery – survived life-threatening conditions because they were physically fit, something they both work to maintain. In fact, she won WELCOM’s “Spirit of Wellness Award,” which honors a leader and innovator in our community for their passion and advocacy concerning the WELCOM mission.
A community leader, Schaefer sits on the boards of many organizations. She loves to run and has more than two dozen marathons under her belt.
Public Health Issues
There are so many public health issues she has been instrumental in improving. During her career as a medical officer, “She was assigned smallpox preparedness planning, both pre-event and mass vaccination post-event,” Rep. Terry wrote in his nomination letter. “Because of her skillful planning, Nebraska was the first state to be ready to respond to President Bush’s call to vaccinate public health and health care workers.
In three short weeks the vaccinations were complete and we were the first to have the right people vaccinated, able to respond to a potential release of the deadly smallpox virus and we had the highest per capita rate of vaccination,” Terry said.
“Dr. Schaefer’s second task was to prepare Nebraska to receive, secure, break down and dispense the Strategic National Stockpile and, because of her thoroughness, we became just the fifth state nationwide to be approved by the Centers for Disease Control to receive the Stockpile.”
“Many states are now adopting our ideas,” Schaefer said of Nebraska’s bio-terrorism preparedness efforts. “While I realize the very sad prospect of having to do such a task, I am proud of Nebraska and honored to [have been] entrusted with the care of its citizens.”
In another public health ini-tiative, Schaefer had been working with the Charles Drew Health Center and became concerned about the state’s high infant mortality rate, particularly in that area of the city. When she was appointed deputy medical officer, she said she began “bugging” the then-chief medical officer about it, asking what she could do to help. This led to her being appointed to develop a solution.
She chaired the Child Death Review Team that reviews all deaths of children under the age of nineteen in the state for analysis of cause and prevention and make recommendations to protect the youth of Nebraska.
Under her purview, the team reviewed over 1,800 cases of children’s deaths from 1996-2004 for nature and cause of death for preventability and trending.
The findings led her to implement a multi-pronged approach to help educate new parents, including a shaken-baby program and a back-to-sleep program.
Blue Cross Blue Shield
Of her newest position, Schaefer said, “I am having a great time now because there’s so much change happening in health care and I feel like I’ve had all of these roles.” She said her Blue Cross and Blue Shield role is “extremely fulfilling,” enabling her to use creativity and innovation to make a difference in members’ lives.
Schaefer’s background in family practice, along with her public health and state government experience, gives her a unique perspective on the challenges of a complicated, rapidly changing health care system.
In such a dynamic and fast-paced environment, Schaefer said she’s proud of the work she and others at Blue Cross and Blue Shield of Nebraska are doing to change the health care system and improve the way medical care is received and paid for.
Her advice to young leaders is to “be passionate about your work, learn your work and know yourself. Try to be a really good leader and a lifelong learner, look for good opportunities to serve and good things will come to you,” she said.
Even on the tough days when things don’t go to plan, Schaefer has a ritual that her father taught her to get through the tough times: “At night look in the mirror, say ‘tomorrow will be better,’ remember to accept mistakes you have made, learn from them and make the next day better.”
If you or someone you know needs help, call the National Domestic Violence Hotline at 1-800-799-SAFE (7233).

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