For many physicians, patient care begins and ends in the exam room. Ellen Shank’s career tells a different story. By engaging in health policy, she has translated daily clinical experiences into legislative change — improving care not just for individual patients, but for entire communities.

Shank’s entry into health policy began as a fellow in the Department of Emergency Medicine Health Policy and Administration Fellowship program at UC Davis Health. Through the program, for two years she worked closely with state and local government officials, spending significant time at the California State Capitol and learning how policy decisions are shaped — and changed.

“Sometimes the most powerful way to help the person in front of you is to change the system behind them,” shared Shank. 

“Sometimes the most powerful way to help the person in front of you is to change the system behind them.”—Ellen Shank

About the health policy and administration fellowship

During her fellowship, Shank served as a board member and health advocacy fellow with the California chapter of the American College of Emergency Physicians (California ACEP). She worked alongside experienced advocacy staff, spent time at the Capitol engaging in emergency medicine policy discussions and accompanied California ACEP lobbyist Tim Madden on legislative visits. 

Along the way, she learned that some of the most effective advocacy happens outside formal meetings — through brief hallway conversations and informal exchanges with lawmakers and their aides.

“Lawmakers rely heavily on legislative staff to screen bills, lobbyists and constituent requests,” explained Shank. “In many cases, meeting with a staffer can be just as consequential as meeting with the legislator.”

At the same time, Shank served on the Sacramento County Public Health Advisory Board, where she met monthly with county leaders to elevate urgent local public health issues to the Board of Supervisors. The experience offered a valuable counterpoint to state‑level work and deepened her understanding of how health policy is shaped across multiple levels of government.

“My greatest value was bridging the gap between policy and practice,” said Shank. “As a physician, I could identify which ideas would meaningfully affect day‑to‑day emergency medicine — something that isn’t always intuitive to legislators or their staff.”

Putting experience into action

That clinical perspective directly shaped Shank’s work on AB 447, authored by Assemblymember Mark González of Los Angeles. The bill allows emergency departments to provide patients with the unused portions of their multi‑use prescription medications upon discharge. This way, patients can go straight home with the medication instead of having to stop by a pharmacy to order it.

The legislation was grounded in front‑line realities, recognizing that how and when patients receive medications can be just as important as the prescription itself.

Seeing AB 447 signed into law in October was deeply rewarding for Shank. Although implementation has taken time, UC Davis Health is now actively preparing to roll out in-house prescription labeling for multi‑use medications — bringing the policy directly into clinical practice.

“The impact on patients — particularly those with lower health literacy, limited resources or unstable housing — has the potential to be substantial,” said Shank. “Providing medications directly at discharge removes common barriers like transportation challenges, pharmacy wait times or prescriptions that go unfilled altogether. This is especially meaningful for medications we prescribe every day, including eye drops, topical treatments and albuterol inhalers.”

The benefits are especially clear for pediatric asthma patients, Shank added. Ensuring that a child leaves the emergency department with an inhaler already in hand, rather than relying on a delayed pharmacy pickup, can reduce return visits and improve outcomes. 

AB 447 demonstrates how clinically informed policymaking can lead to practical, patient‑centered solutions with real‑world impact.

Sharing her experiences

Now a faculty member in the Department of Emergency Medicine, Shank teaches medical students, residents and community groups how to track legislation, communicate with elected officials and be effective advocates for their patients.

“One of my favorite moments is watching the realization dawn when learners understand that tangible clinical change — like AB 447 — can come directly from physician advocacy,” she said. “Legislators genuinely want to hear from constituents, especially when clinicians can point to practical, patient‑centered solutions to everyday problems. If something feels like common sense in your clinical work, there may be a straightforward legislative fix, and lawmakers are often eager to champion those ideas.”

The Health Policy and Administration Fellowship is particularly well-suited for individuals who enter the academic year with clear policy interest and are seeking the tools, mentorship and relationships to act on their passion to advocate for their patients. 

For emergency medicine physicians in particular, the fellowship reflects the growing reality that the emergency department sits at the crossroads of medicine, public health and policy.

“There is a real opportunity to help shape how medicine is practiced,” added Shank. “And there is always room at the table for more voices.”