M.D., M.P.H., M.S., F.A.A.P.
2010–12 ROBERT WOOD JOHNSON CLINICIAN Scholar
William R. Long Director of Child Health Policy, Vanderbilt Center for Child Health Policy
Professor of Pediatrics and Health Policy, Vanderbilt University
Stephen Patrick, M.D., M.P.H., M.S., F.A.A.P., completed the Clinical Scholars Program in 2012 during a fellowship in neonatal-perinatal medicine at U-M. He is now the William R. Long Director of Child Health Policy at the Vanderbilt Center for Child Health Policy and a Professor of Pediatrics and Health Policy at Vanderbilt University, dividing his time between active clinical practice in neonatology and research focused on improving outcomes for pregnant people and infants, particularly those affected by the opioid epidemic. Patrick also serves as the Executive Director of Firefly, a Center for Medicare & Medicaid Innovation model that aims to better coordinate care during pregnancy and the postpartum period for people with opioid use disorder and their infants.
Patrick has taken on a number of high-profile government positions since completing the CSP, most recently as a senior policy advisor within the White House Office of National Drug Control Policy, where he headed up an interagency policy committee that resulted in the Biden Administration’s action plan on substance use disorder in pregnancy. He has also served as an expert consultant to the Substance Abuse and Mental Health Services Administration, a guest researcher at the Centers for Disease Control and Prevention, a voting member on several Food and Drug Administration Advisory Boards focused on opioid use in children, and an advisor to the Tennessee Department of Health’s Division of Family Health and Wellness. He has also testified before U.S. House and Senate committees about the impact of the opioid crisis on pregnant people and infants.
The Vanderbilt Center unites investigators across fields such as pediatrics, obstetrics, education, biostatistics, economics, divinity, and many others in its mission to improve the well-being of children and families through research and clinical innovation. Its Child Health Poll regularly provides timely insights into the issues facing parents and children in Tennessee – such as understanding changes in healthcare access, firearms and school safety, vaccine hesitancy, and mental health – and the team often fields polls on topics it anticipates the state legislature will be addressing.
When COVID-19 emerged in the U.S. in early 2020, the team conducted rapid national polling to assess the pandemic’s early effects on the physical and emotional well-being of kids and parents across the country. As policymakers were considering various measures to mitigate the health and economic effects of the pandemic, the poll’s findings were used to brief the Senate HELP Committee staff on the unique challenges facing parents and children, and were also cited by the U.S. Surgeon General.
“When we think about what improves the well-being of children, if you ask parents and you look at the kinds of things that families need, a lot of them are outside the healthcare setting – things like food security and schools,” Patrick says. “So our research focus has broadened to consider those needs and their impact on health.”
“Around the opioid crisis, we've started to focus on more on the child welfare system and related policies. What's working, what's not working? What are the unique challenges in the system? How might approaches to improving treatment and access to treatment in pregnancy improve child welfare outcomes?”
Patrick and his team conducted an experiment across 10 states comparing the experience of pregnant women vs. non-pregnant women (as represented by simulated-patient callers) attempting to access treatment for opioid use disorder (OUD). The study found that being pregnant meant the caller was less likely to get an appointment with an OUD provider. The study also found significant barriers to accessing treatment for all women, including a large portion of clinicians who required cash payment for appointments and did not accept insurance. “If you're pregnant, if you can't afford to pay cash, then it can be really challenging to access OUD treatment,” Patrick says.
One of the issues Patrick studied while still at U-M was the impact of opioid use on maternal and infant health. He was lead author of a study published in the Journal of the American Medical Association which estimated that the number of newborns experiencing withdrawal symptoms due to their mothers’ use of opioids during pregnancy more than tripled between 2000 and 2009, resulting in one baby born every hour in the U.S. with this issue.
“The program taught me how to think beyond the primary question I was studying, to see how my research could eventually shape policy.”
– Stephen Patrick
After Patrick moved to Vanderbilt, he published a study of infants born with neonatal abstinence syndrome (NAS) as a result of opioid exposure in utero in the Journal of Perinatology. This research highlighted significant differences in how children’s hospitals treat the condition. “The study demonstrated for hospitals and policymakers the need to provide standardized, evidence-based treatment to all of these infants,” Patrick says. He has continued this work on NAS, and has been cited more than any other researcher in the world over the last decade on the topic.
Patrick looks back on his training as a Scholar as an inflection point in his career. “It taught me how to think beyond the primary question I was studying, to see how my research could eventually shape policy, and which approaches to use to both generate robust data and translate it effectively for policymakers,” he says.
“The analytic foundation of the program allowed me to think more broadly about what I saw playing out in the clinical environment,” he says. “The team building, leadership, policy analysis, all those things were really formative for me, and gave me the skills to be able to do the work I do today.”