Current Job: Health System Chief, County of San Mateo
YLS year: 1989
Clerkship: Judge Barefoot Sanders, Northern District of Texas
Activities at YLS: YLW, international law journal, clinic
Tell me about your career path after law school, and how you got to your current role.
I spent my three summers during law school working at law firms. I worked there to reduce the debt I would have when I came out of law school, and to see if I liked it since the money was alluring. Actually, I really disliked private practice; in the huge NYC firm, I did nothing interesting, just looked at boxes with tens of thousands of documents. I remember thinking that you couldn’t pay me enough to do this as a career. After those experiences, I was sure I did not want to go into private practice.
I did a great clerkship, and then I applied to the Department of Justice Honors Program. I wanted to live in San Francisco and at that time the only Honors position was in the Antitrust Division so I took it even though I knew nothing about antitrust law. As a prosecutor, the attitude was so punitive and so lacking in an appreciation for the subtlety of most situations. I almost quit in the first few weeks. But I stuck it out for a year and then I moved to the San Francisco City Attorney’s office.
Finally, I had found a job I loved! I was on the trial team at the City Attorney’s Office, and frankly, it was better training as a litigator than I could ever get working in a law firm. On my first day I was handed a caseload of 50 cases and told I had an arbitration the next week. I had to ask what an arbitration was and where I would sit when I walked into the arbitration. It was so much fun learning by handling cases on my own. I did about 200 depositions, 50 arbitrations, countless motions, and 12 trials in just four years. I learned how to take a good deposition because I had to use the deposition transcripts to impeach witnesses at trial. And I learned the reality of who can sue for what kinds of damages, and which cases lawyers will actually take on.
Plus, I represented every kind of government function you can imagine—medical malpractice by paramedics, wrongful death when a tree limb fell and killed a stockbroker picnicking in Golden Gate Park, a police excessive force claim when an off-duty police officer chased after a man who had stolen a woman’s purse and ended up shooting the thief. I learned how the cable cars worked, what really worried the politicians, how civil service rules work and why we need them. I felt such a thrill standing up in court saying “Your Honor, I am Jean Fraser, representing the City and County of San Francisco.”
There are two main advantages to working for the government. First, it’s fast—not like a firm, where too often you are buried in discovery for years. Second, you get to know your community and how it works. And bonus points for knowing the real stories behind the headlines in the newspaper!
It was fun, but doing litigation has so many emotional ups and downs. In the end, I discovered that for me, the highs of winning weren’t worth the lows of losing. And I had always wanted to change the world for the better, not argue about blame after things go wrong. So at age 30, I took a six-month sabbatical. I came back to the City Attorney’s Office to work on the counsel (not litigation) side, becoming general counsel for the Departments of Health and Human Services. That was fascinating work, learning a whole new area of law—health law—and dealing with real life problems such as when the hospital called to say that the husband of a woman on a ventilator wanted to take her off life support, but the hospital believed the husband was the one who had beaten her unconscious. Did they have to follow his decision as the next of kin, they asked? I had to tell them what the legal rules were and help them make the decision.
After working on the advice side for about four years, I decided I was done advising people who were trying to make the world a better place; I wanted to try it myself. So in 2000 I was lucky enough to be selected as the CEO of the San Francisco Health Plan, a government HMO. We created a program to provide universal health insurance for children and then created a program to provide universal health coverage for all uninsured in San Francisco (this is way back before the Affordable Care Act). I had to learn accounting, management, marketing, IT and a million other things on the fly; it was great fun doing great work.
Since then, I’ve continued in public service. I’m currently the Chief of the San Mateo County Health System, which means I run the health department for a county with 750,000 residents—more residents than the entire state of Vermont! The Health System has 2,100 employees, a $500 million budget, and involves everything from running a hospital, providing mental health services, caring for low-income elderly folks, making sure the food we eat is safe, dealing with measles outbreaks, and everything health-related in between. I even have animal care and control!
Every day is different and challenging and interesting. Some days are incredibly frustrating, but I cannot imagine a more fascinating job. I love to learn new things, and I am comfortable making decisions without all the details. You can’t beat running a large, complex government agency for interesting challenges and opportunities to make real people’s lives better in so many ways.
2. LAW SCHOOL
What activities were you involved in at law school? Which ones were most valuable during your time there?
I helped start the Student Funded Fellowships. I was Editor-in-Chief of the international law journal. Also, I loved clinical work; Professor Jay Pottenger is still a dear friend. The clinical work I did representing prisoners has been invaluable to me in my career as a prosecutor, a litigator who defended a county from lawsuits by inmates, and now the head of an agency that provides all the medical and mental health care in a jail and tries to advocate that mentally ill people should be treated, not put in jail.
How did your experience help your career?
I found my legal training invaluable. I don’t know how people run complex organizations, particularly in highly regulated fields, without being a lawyer. What has surprised me is how useful working as a litigator has been. First, when I was general counsel, I was able to give much better advice since I was not afraid of defending my advice in court. Second, I’m a much better risk-taker as the head of a complex organization. I can act knowing who can sue for what and how good their case is, having seen what motivates plaintiffs and defendants, and what motivates their attorneys to take, reject or settle a case. I also learned how to present my case persuasively and concisely, think on my feet, and make decisions quickly—skills I use all the time.
You mentioned taking the sabbatical at age 30 and leaving the litigation team. What turning points have you faced in your career—what guided you, where did it lead you?
Two decisions: I debated getting a JD/MBA, but was persuaded by an SOM professor that I could learn the MBA stuff on the fly. So far, he has been right, but I have to acknowledge that having a Yale law degree opened career doors for me that I might not otherwise have had without an MBA.
Second decision: Taking the big leap of becoming a CEO with no background in business. Scary, but very motivating to educate myself quickly!
As a lawyer, it’s your job to give advice, not to make the decision for the client. It was scary at first to have to make my own decisions and live with the consequences, but now I really enjoy it. In my current role I have to assess risk and make decisions every day, and if I make a bad one, I have to be able to recover and move on. I have attorneys now who advise me, and I rely on them to give me the lay of the land. But in the end, I make the decision, not them.
You mentioned the litigation lifestyle being difficult. Did the transition allow you to have more work-life balance?
Let me clarify, with litigation the problem was not my family. What I meant is that litigation has ups and downs, and I didn’t like losing. It was too difficult. The highs were not worth the lows.
With respect to family, it’s a balancing act. And the higher you get, the more flexibility you’re able to have. But not all at the same time. You have to decide what really matters to you. I’m not one of those mothers folding napkins at my kids’ school. It’s great for some people, but I’m just not doing that.
Do you have any personal words of advice for current law students, and women in particular?
Yes, I have four aphorisms that I often share:
1) Do what you want and enough money will generally follow.
What makes most of us happy? Doing work that we find challenging and fulfilling. Then we need to spend less money making ourselves feel better during our leisure hours. If what motivates you is money, then follow that. But if you’re good—and let’s face it, if you’re at Yale, you’re good—do what you love to do, and generally you will find a way to make enough money to have a good life.
2) It really matters who your partner is.
Doing what you love requires having a partner who will support you (and you will support her/him) in doing what you love. See Rule #1.
3) You can do everything in life, but not all at the same time.
4) Cut to the chase.
See Rule #3. Once you pick those things that matter to you right now, let the rest of it go. For example, I love having great work and I love being home for dinner with my family at 6:30 almost every night, so I don’t do evening work events. There are downsides to foregoing the evening events, but I just don’t worry about it because I am doing what matters the most to me. The key is not to feel guilty about your decisions.
5) A special rule for women: Don’t undersell yourself to yourself or anyone else.
Are there any other lessons you might draw from your former classmates? Any last words of advice?
My friends from law school have gone into many different areas—big law firms, public sector, advocacy, teaching, etc. But no matter the area of law, the ones who are happiest are those who pursued things they really care about.
You know, life is really interesting, especially when you get off the beaten path. For me, working in public service for a large urban county has been profoundly gratifying in that I get to make change and I am constantly learning new things. I am so grateful that the education I got at Yale encouraged me to think big about what a law degree could do for me.