Dr. Danny Avula shares his inspiring leadership journey from his roots as an immigrant child from India to top roles in public health and social services in Virginia.
Danny dives into how experiences like moving to an underserved community influenced his approach to serving communities. Avula also reflects on key lessons like listening to lived experiences and adapting to technology.
Listen for insights on navigating diverse career paths and building more inclusive communities.
Show Outline
- 0:00 – Danny’s career path
- 2:56 – Personal journey from immigrant kid to medical school, then to non-clinical work in public health.
- 9:29 – Career development in public health.
- 15:16 – Public health, and politics with a focus on bridging gaps and connecting communities.
- 21:51 – Community and social justice in Richmond, Virginia.
- 27:57 – Technology and community engagement.
Connect with Danny
Full Transcript – Episode 65
Aaron Lee 00:00
Sometimes you meet a leader who really stands out to you sets the bar high and is somebody you know, is a leader worth following. That’s what Danny Avila was for me in my nonprofit days, as he served as a member of our Board of Directors, watching Danny’s career since those days with the nonprofit, as he’s moved from the Health District, to serving our state, to serving social services across the Commonwealth. Every time I see another story, another headline, another experience that somebody has with Danny, I’m continually impressed by his intentionality and his leadership. He is living out what I saw back in those nonprofit days. Today, we sit down with Dr. Danny Avila, known as Richmonds, Dr. Fauci during the pandemic era. He is a committed leader focused on strengthening our community, his community. To make it better for all citizens. I think you’re gonna take a lot away from this conversation with Dr. Danny alula. Let’s dive in. Welcome to
Jay Smack 01:11
the new generation leader podcast, we’re giving you the tools you need to lead in the digital world ready to reach your true potential. This is the new generation leader podcast.
Aaron Lee 01:24
Alright, Dana, your story follows a meandering path a lot of different directions, and the time that we’ve known each other, from nonprofits, from the nonprofit world into what you’re doing today. But take us back to the beginning. If you set your sights, similarly to how I did on, I have a destination in mind, what was the earliest point in your life where you realized, Hey, this is what I want to do with my life?
Dr. Danny Avula 01:53
Yeah, well, that goes way back to the beginning. I mean, I think the reality of being an Indian immigrant kid growing up in this country, means that that imprinting happens real early on, you know, I remember, probably sixth or seventh grade was the first time where I was like, I’m gonna be a doctor, like, that’s what I want to do with my life. But that work, you know, started from birth, you know, I was born in India, my family immigrated here, spent early years in California and Philadelphia, and then ended up in the DC area. But all along that path, I think everything that my parents were doing, either consciously or subconsciously, were, you know, kind of steering me to a decision that it was either gonna go into medicine or it because that’s what it needed kids to do in this country, you know, so that that was, like I said, imprinted real early on it’s it’s no accident that we have so many Indian physicians in this country, right, my myself, my younger brother is also a doc, he married a delightful Indian woman who is also a physician. And so you know, that I think it’s just part of the story for this subset of immigrants coming to this country. And so from that early Middle School on like, everything I did, again, not even consciously, necessarily, but the summer camps and the school programs and volunteering at the hospital every Saturday, all of it, you know, what was kind of charting the course to eventually go into medical school.
Aaron Lee 03:25
So you talk about that decision and setting that vision in your middle school years. And looking back now you see the cultural influence as immigrant Indian family. When did that kind of click for you that your story, your family’s journey, was something different than what classmates had experienced growing up?
Dr. Danny Avula 03:55
I think, probably about that same time, I think middle school, high school, you know, as an immigrant family, our social network was other Indian families. And I think I became pretty conscious at that point, that there was this kind of comparison and one upmanship between different families, and the pride that exists for parents saying, oh, yeah, my son’s going to medical school or my son is going to be very successful, right? Like that is just part of the immigrant culture. Because the whole reason that folks come to this country is to pursue the American dream and to make sure that things materially in many ways and maybe in other ways, but but are better for the next generation. And so I definitely, like tangibly, remember those conversations among parents where, you know, I went to this like super nerdy Science and Tech High School in Northern Virginia. And, you know, my parents were so happy when I got into TJ and it was this point of pride that they could take to the Indian community and say, Look, my son so I think I started to feel that early on. And in high school, you know, there were a large Asian population, both South and East Asian. And so you, we would all have those stories to compare of like the the pressure or brainwashing that we’d all been exposed to at some point.
Aaron Lee 05:20
So you keep on that journey, pursue medical school, and get into medicine. Talk about your journey in how you’ve now in the last few decades shifted out of direct medical practice. Yeah. What, what precipitated that shift for you? Yeah, I,
Dr. Danny Avula 05:43
you know, I think, going back a little bit to the path to medical school is important here, because I have known since middle school that this is where I was headed was just on this fast track, right, like, every thing that I was doing was checking the box so that I could do the next thing that would get me into medical medical school eventually. And so I was racing through life, you know, I graduated high school at 16. I finished college in three years, graduated college at 19. went to medical school. And and and I think my third year of med school was that at that point, the transition from you know, your first two years of mostly classroom to the second two years of of actually doing your rotation seeing patients became this realization and crisis moment in my life, because I was going through the motions of actually like, seeing patients in the OB rotation or in the surgery, rotation, and each one leaving being like, man, is this what I want to do for the rest of my life? And each rotation that went by the answer, in my mind was more firmly No, to the point where I actually thought about quitting med school because I was like, if I don’t want to do clinical medicine, I don’t want to do traditional clinical work, what other pathways are there. And thankfully, my wife, who is much more patient and wise than I am, said, You know, you’ve got a year left, like, let’s just get the degree figure it out. And it was such a helpful, grounding. Because what it did was it forced me to really explore what other pathways are there. And what do you do with this degree in this training, if the clinical approach is not is not really what, what you’re about? And I think probably the other thing I should say is that because I was on that fast track, and I was just racing through school and doing like, the pre med curriculum, and, and, you know, kind of the things that I needed to do to get to med school, I think I really missed an opportunity for, you know, self development and exploration about like, who am I and what am I really interested in? And what am I created to do on this earth and, and that was unfortunate, because like, the University of Virginia was an amazing place. And I could have had so many opportunities to explore sociology or philosophy or, or, you know, macroeconomics, who knew who knows what I would have been interested in. But because I was a bio major, like on this med school track, I kind of just sailed through without really taking advantage of that. And so I, my fourth year, so fast forward to clinicals, in fourth year of medical school, I was for the first time really was pushed us to think about, okay, what what do I want to do with this. And so thankfully, my advisors in med school were really supportive. And I ended up doing a very non traditional fourth year of med school and pursued rotations and administrate sort of the business of medicine, in in leadership in medicine, my wife and I did a month abroad in Kenya, looking at international global health. And then I did a month at the state health department and the month at the local health department. And that was my first exposure to public health and just absolutely fell in love. Because what I realized was that while I was not motivated by sort of the science of medicine, or that individual clinical setting, what I was really interested in is how culture and communities and policy and sort of the big picture of what’s happening in communities actually impacts the health of communities. But I didn’t have words for it. And I didn’t, that’s not what med school education at that point was, was teaching. And so I had to go through this exploration process to find these things that really connected and resonated with me.
Aaron Lee 09:29
Let’s dig in just for a minute. You mentioned the influence of your wife posing the question, hey, let’s have some persistence here and just finish, but also the support of advisors being willing to kind of open that box open to your world. I feel like a lot of times and I was on this similar parallel track set from high school on on one journey. And now as I look back I see See the variety and being able to put the connecting pieces together. But I feel like a lot of people don’t either have that opportunity take that opportunity, or they don’t have those voices who are asking those questions. What was it in, in that support network around you, that really helped you even be willing to take that step and explore other potential paths off of your core job.
Dr. Danny Avula 10:34
I think to some degree, it was like, a belief in me like when you talk about my wife and I and her support, and just saying, hey, like, you’ve got a skill set, you have, you know, dreams and passions, and there will be a way for you to make a difference. And like, let’s say the course and explore that together, right. So I think in that context, it was her believing in me and me feeling that support and encouragement to like, do the non traditional thing. Similarly, I think for my med school advisor, Dr. Whitehurst Cook, who also believed in me, like knew that I had a passion for vulnerable populations, and was willing to trust because there wasn’t a lot at that point that the med school like a lot of non traditional paths, and so a lot of that I had to do on my own, I had to get out there and network and pick up the phone and call people and, and have coffees and explore, you know, the these non traditional routes. And to have my med school advisor saying, absolutely Danny, like that, like we will work with the schedule and the ACGME requirements to, to make that work for you. And so that was extraordinarily meaningful, and clearly, like changed the course of my career.
Aaron Lee 11:51
Fast forward on that journey, we met, really at an intersection that I would imagine is the part of the benefit. And the results of that journey is we met in nonprofit world focused on families while you were leading the local health district, which at the time, if I remember correctly, was straddling both the city and the county. So fast forward on on that journey, and the intersection of worlds that you started to work in? How did you develop the skills? And what did leadership look like in those worlds where you’re bringing people together from multiple disciplines?
Dr. Danny Avula 12:40
I do think in some ways, that’s the beauty of the public health lens is that what we are trained to do. So I am a double A physician that’s double boarded in pediatrics and preventive medicine. You know, part of my residency journey was a pediatrics residency, and then a preventive medicine residency to really look at the big picture, right? Like, what are the things that impact the health of communities, it’s more than just health care. Although that’s an important part of what determines health outcomes. It’s also the education level of your family and the income of your family and the stability of your family, the amount of trauma that you’ve been exposed to through childhood, like there’s so many different inputs. And so learning that what we call in the public health world is social determinants of health. Learning that lens really helps equip me for a different kind of health leadership in the Health Department. And so so much of the early work that I did when I was leading the Richmond and subsequently the Richmond Henrico, health department’s was shifting away from that traditional medical model where we were just providing direct services and, and really thinking more about, what are the health outcomes that matter in a community, we’re going to look at infant mortality, are we going to look at chronic disease rates, diabetes rates? Are we going to look at life expectancy? And what are the things that you can move because it’s a really different perspective, right? Like when I’m, I still do practice as a pediatrician. And so I often share this, this example of the difference between the clinical and public health lens, right when I’m treating a patient in the hospital, kid comes in, he’s gotten pneumonia. I diagnosed that pneumonia with a chest X ray, and then I treat with oxygen and IV antibiotics and IV fluids. And then in a day or two, that kid gets better and can be sent home. The diagnosis and assessment process for communities is really different, right? It’s looking at data and it’s it’s extracting that data stratifying that across race or income or neighborhood and then starting to like look at the root causes of why is it that you see poor health outcomes in particular neighborhoods? And then what are the treatments for that? It’s not just writing a script for antibiotics, right? Often it’s education or it’s increased Seeing access to care, or it’s changing policy that might allow for more healthy foods to be accessible in low income communities. And so it really is a frame shift in the way that we think about health and healthy communities.
Aaron Lee 15:16
You’re weaving together so many worlds. And thinking about it in terms of data, you’ve talked about networking, the root cause. And I think we talked just before we started recording about the root cause of our own leadership tendencies, how we lead why we lead what we do in reacting or responding that was part of your story based on your, your vision of where you wanted to go. And, and I think so often we miss those root causes, and really digging in, we want the easy fix, we want the easy solution, we take the short path, and don’t ask that question a few times as, as Toyota, did, you know, what’s really going on? Why, or why that and why that. And so you’ve you’ve laid out how you see from a public health lens, health and well being, and, and family and community. And so now, fast forwarding, again, the the latest chapter in your journey, you’re venturing into local politics. At a time where politics is a little bit volatile. Maybe there’s no little politics is volatile. And yet you see things with that connective. How do we put the pieces together lens? So what was that shift? Like for you? And that sense of calling and direction to? Hey, let me let me get after this. Yeah, local politics. Yeah.
Dr. Danny Avula 16:59
Well, just to recap a little bit about the last few years of my career, you know, I was a longtime local public health director for Richmond, Henrico health departments, as we just talked about, so much of that work as the local health officer was understanding those root causes and thinking differently about how we improve health and opportunity. And there were so many times in that role as local health director, where I would look to my colleagues who were in economic development or in public works, and say, you know, you guys have as much to do with the health outcomes of residents of this community, as I do as the public health director. And so there was this journey that we were all on together, of understanding that like health is not just about do you have access to a doctor or not, but it really is all of those other social determinants that we’re talking about. It’s about family stability, and access to safe space and safe communities and stable housing. And so, you know, that was the beginning of kind of thinking more broadly, about how my leadership and the roles that I would eventually pursue, would could could impact communities and could could actually do good in this world. And all of that, in some ways, was interrupted by COVID. So COVID hit, and that became like 200%, of what we were doing at the local health department, first navigating the local community through that crisis. And then in 2021, the governor asked me to come to the state and lead Virginia’s COVID vaccination response. And, you know, undoubtedly, was the most intense season of my life, but also the most gratifying, I mean, we were for for months on end working 100 plus hour weeks, and it was just crisis all of the time. But in at the end of the day, you know, we saved hundreds, if not 1000s of lives through the effective distribution of life saving vaccine. And, you know, when I, when I moved into that role, we were 49th out of 50 states in terms of vaccine efficiency getting getting people vaccinated. We dropped to 50, the next week. And then by the time that I left that role, we were top 10 Most vaccinated states in the country. And so the process of like pulling this very diversified, multi talented team, not just from the health department, but from logistics, and from the IT department, like really having all of those different skills come together and recognize like we’ve we’ve never faced a crisis of this complexity, and you really need all of these different talents at the table. And then to see what we did as a state was just like, incredible. It was an incredible season of work. And so, you know, we came out of COVID and change of administration’s I was one of the few folks who was held over from the previously led Democratic administration to the newly lateral Republican administration. but was able to take that skill set of managing through crisis and my my background in public health. And to move to the Department of Social Services over the last two plus years, I’ve been leading the state social services agency. And you know, you, you rewind to that whole conversation about the social determinants of health. Remember, it’s so much of what determines health, our access to jobs, access to income, financial stability, housing. And that’s what we were doing in the social services world, we were figuring out how do you come alongside lower income families, get them acute access to the financial stabilizers that they need, but then really helped map a pathway out of poverty. And so that work that we were doing in the social services realm, to give people a goal and hope and, and to support them on their own pathways, really, again, had so much to do with the health of communities. And so ultimately, all of it ties together in in lots of different ways. And so after doing that, for almost two and a half years, this opportunity to get back to local work, which has been such a huge part of my career, and my life opened up and I just couldn’t say no to the chance to lead the city that I love. And so that’s the that’s the reason that’s the why behind jumping into local office, and I think, to your earlier points about the polarization that exists politically, I think that’s true. And I think that that’s all the more reason for people who have, you know, worked in local communities and, and been able to kind of straddle and connect and bridge builds. Like, that’s the kind of leadership that we need. And I think that feels different at the local level, right? Like, we’re not delving into super partisan issues. We’re trying to figure out how do you make the city work better? And how do you make the city work better for everybody who lives in it?
Aaron Lee 22:00
And that’s certainly been a challenge in this city, not just in recent years, but for decades, if not, centuries. And so taking that comprehensive view, and the the intense focus on the betterment of community is something worth following. And as, as we’re working to build leaders who people want to follow, it’s some of that connective tissue that, hey, let’s put together the pieces. Let’s tie the threads together, and see how these parts work together. That is really worth following. So thinking about leadership, and zooming out a little bit from your personal journey, and personal path and what you’ve seen. I want to ask you about key influencers along the way. Who were the leaders in your journey that stood out to you that gave you a model or something that you wanted to follow? Yeah.
Dr. Danny Avula 23:11
I’ll start with a man who I only knew from a distance and met in person in more recent years, but Dr. John Perkins was a pastor, a civil rights leader, community activist down in Jackson, Mississippi, and Dr. Perkins is known for a lot of different things but probably best known for his work built bringing black and white communities together to live together in community with real intentionality around racial healing work. So when I was in college, I was a part of a group of friends that that would, that started going to alternative spring break trips down to Jackson, Mississippi actually never went, my wife did a number of my roommates did, but they had
Aaron Lee 23:53
metal medical school.
Dr. Danny Avula 23:55
That’s right. But they, you know, they it was palpable, like when they came back to the university, how their vision was being changed, and how their desire to like live out that intentionality and racial healing work was playing out on grounds. And, and so fast forward a few years to this point, a few years out of college where a group of friends had this opportunity to pursue grad school to pursue residencies, to move to a different place. That model that Dr. Perkins had had lived out, really was front of mind for us. And so that became the seed that planted that ultimately, four of my best friends in the world who were all roommates in college and, and their spouses all made a decision to move into what was a very low income, predominately African American community in the east end of Richmond over 20 years ago. And so, you know, Dr. Perkins influence on us has has persisted and Being in this community for 20 years, has been beautiful in so many ways of meeting and living alongside and being in deep relationship with neighbors that I just wouldn’t have come across had We not made the choice to live in that community. And it’s changed everything about how I approach my life as a friend and neighbor and how I approach my leadership roles in the city and state, right, like my work as the city’s health director is substantively different because of the lived experience of my neighbors who would share with me their challenges in finding access to a doctor who would share with me the difficulty that they would have, trying to navigate the Medicaid eligibility process, right. And who knew that years later, I would ultimately be the person responsible for that for the whole state. But the fact that I had had those like, experiences with people who were who were struggling to get access to services, because we just when we create these systems, we’re not thinking about the end user, we’re not thinking about the hoops that they have to jump through, we’re not thinking about the dehumanization, that happens when you have six different case managers who are asking you to provide your pay stubs and and basically prove that you’re poor enough or not poor enough to get access to services and, and so that taught me a lot to kind of see things through the eyes of my neighbors. Now, it has not been all pretty, because the reality of us moving into that community is that over time, that has led to the displacement of many of my low income neighbors who could no longer afford to live in that neighborhood. And so we’ve had to grapple with that reality. And think about what are the policy solutions and practical solutions that we need to pursue as a city now, to be able to maintain long standing residents of a community and to be able to maintain sort of the the beautiful tapestry of of people across race and income and experience to be part of community together? And so as I think now about why am I get why am I running for mayor? Why am I getting into the local political fray? That’s a huge part of it. Right? Richmond has been on this amazing trajectory, we’re seeing so much population growth. Our our poverty rate, for example, has dropped from 26% to 20%, over the last six or seven years. But that’s not because we’re actually solving poverty, it’s because we have middle and upper middle income folks who are moving into the city. And so it’s diluting that poverty rate, or we’re pushing low income residents out to the counties. And so, you know, part of my hope and vision as a future leader of the city is how do we preserve the long standing residents? How will we create affordable housing? How do we create the kinds of communities that actually can sustain low income and upper income people living together, being a part of a city that everybody can thrive in?
Aaron Lee 27:57
That’s so good. You know, as you talk about your neighbors, and having those real conversations, that’s one of the ideas coming to the table together, sitting down across the table, having a real life conversation that was part of the new generation leader book. And in the course, I teach at the nursing college. That was the assignment students completed last week. And as I read their assignments, which was have a conversation with somebody who has something different from you, in their personality, background, history, generation, whatever, it is just something different and have a conversation with them. It was fascinating to read, sometimes it was doctors that working with on the floor at the hospital, it was neighbors grandparents, there were so many people. And and I think that’s not that it’s a an art, but it is a lost art, to have a conversation and a dialogue, get to know somebody who’s different than you. And, and recognizing, I heard a health leader if a few weeks ago talk about well being within their organization, and how he needs to hear from frontline employees, middle management, and we need to make those relationships closer. And I think that’s what I hear in your story. Your lived experiences, the connectivity and paying attention to what’s going on to different people. We can’t operate in silos. We can’t work alone.
Dr. Danny Avula 29:38
Yeah, that’s true. Yeah. I you know, Bryan Stevenson from the Equal Justice Initiative talks a lot about the power of proximity and like once you are closer to issues closer to people closer to communities that are living through things that you haven’t had an experience with. It changes everything about your perspective and what you were just said Think about the assignment of having a conversation with somebody who’s different than you. I mean, I think that’s the beginning of the antidote to what our society is facing, which is Conversations ultimately lead to connection and relationship. That’s what our society needs for real mutual understanding and respect. And like our current consumption of media, our current political climate, like don’t really allow for that, right. Everything that we’re consuming, is, is pulling us apart. And it’s not until we’re willing to commit to having that conversation with someone across the table. And even more than one conversation, walking alongside as friends and equals and mutual partners. That’s, that’s where we need to head and I’ll just say, you know, from my experience, you know, I shared about how that proximity and those relationships formed me and my leadership in so many ways. But that has translated to the way that I’ve led institutions over the last 15 years, right, like that understanding of people with lived experience and the voice and expertise that they have and bring to program or policy development, like that became the hallmark of our work at the health department and subsequently at the Department of Social Services is that like, we should not be making decisions about policies or about huge financial investments without the input of the people who actually use those systems. And in my most recent work in DSS, a lot of that was really focused on digital transformation. And IT systems and everything that I was saying about the challenge of navigate, like our eligibility application process, doesn’t translate to a smartphone, right? Like you can’t access it through a smartphone. Now, when you think about our low income families in this day and age, they all have access to smartphones. And that is as really their primary access to the online world. And so what are we doing if we’re not adapting it to the way that most people can access information, and potentially surfaces. So a huge part of our work was advocating for investments in in new IT infrastructure, and so that that work is underway now. And that’s super exciting. Similarly, at the health department, when we were expanding clinical sites into lower income communities, we actually decided we needed to get out beyond our four walls and put physical locations in our lowest income neighborhoods was a huge part of that, that was listening to the communities and hearing Okay, what do you guys want to see in this? What would make you use these services? You know, one, funny memory of that was that, you know, part of our funding for that was family planning and reducing sexually transmitted diseases. And neighbors would say, you know, if this is an STD clinic, no one’s going to show up. Because in this community, everybody knows each other’s business. And if you walk in that door, like your, your, uh, you know, everybody will know why you’re there. So and then to hear sort of elderly residents of the community say, I just want a place to check my blood sugar, I just want somebody to help me figure out do I need to go to the ER or not. And so it totally changed our service model by listening to the voices of people in that community. And the other thing we realized was that there are so many people, even in these low income communities who have tremendous expertise in the health realm, and a passion to serve their community. And so we started hiring residents of communities as community health workers. And what we found was that they had so much more connectivity, credibility, ability to reach their neighbors than we did as outside governmental entities. And so that completely changed our, our reputation as a as a service provider in that community. So I think that that arc of listening well to communities, elevating the lived experience that lives there, and being willing to kind of change your model and your construct based on that input. That’s been a hallmark of the way that I have, I’ve approached this work,
Aaron Lee 34:03
incredible lessons, great insights, such good foundational components of leadership that I think we can all pull from, even if we’re not in public health, or politics or medicine. There’s so many lessons we can learn. One final question for you, as you look back on your career, your journey, what stands out to you that you’ve learned recently, that you wish you had known earlier in your career?
Dr. Danny Avula 34:35
I think this is a little bit of a cheat because I did have a mentor at one point who, who sort of helped me with this perspective, but early on in my health department leadership. My friend Karen, who was the State Health Commissioner aside, you know, I think about every step of my career journey as a new residency and so putting it in medical terms you do a residency, which is a super are intense like three year four year training opportunity. And what she was getting at is that each leg of the journey, you really learn something different. And I think about the last two and a half years of leading the State Department social services, I didn’t know anything about it. When I stepped into that role. I didn’t know that’s what the the agenda would be for the next couple of years. And so I had to just deep dive into learning about things like enterprise architecture, and how to manage vendors and, and really building the user experience lens. But now I, in the midst of that, I was like, oh, man, is this what I’m doing? But But what I realized is that for this organization, and every other organization that I’ll ever be a part of digital transformation and adapting technology effectively is going to be a part of the present and future of of institutions. And so I think back over that last two and a half years as another residency where I got to learn how to adopt new technology, and really keep the end user in the center. So it’s an example of where like, you know, who knows where what turns your career is going to take, but there’s something to be learned, and something that you you may not even be able to cast a vision for. But there’s some way that all of those experiences and skill sets come together for whatever the next step is? Well, Danny,
Aaron Lee 36:24
I’m excited to see your next tour of duty. What that tour looks like, what that next chapter holds, and the chapters beyond it, because I know from watching you back to the nonprofit days, you were one of our our board leaders. So a leader who was even at that time I could tell a leader worth following, and who I did follow in those days. And it’s it’s been a joy to watch your career. Unfold. And thanks for your time today and unpacking your story.
Dr. Danny Avula 36:56
Thanks so much and great to be here.
Jay Smack 36:57
Thanks for listening to the new generation leader podcast. Subscribe today on your podcasting platform. Download the show notes and unlock your true leadership potential at New Generation leader.fm. Thanks for listening today. And we look forward to seeing you next time on the new generation leader podcast.