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There’s a new face at the helm of the city health department.
Cheryl Bettigole took over as acting Philadelphia health commissioner after the abrupt resignation of her predecessor, former Commissioner Tom Farley. After five years in the position, Farley stepped down in mid-May on request of the mayor after admitting he’d mishandled remains of MOVE bombing victims.
It’s unclear how long Bettigole will stay in the role, as a national search is underway for a permanent replacement. But the position has arguably never mattered more.
Her department is about to be deeply scrutinized, as the city launches an investigation into Medical Examiner’s Office policies around remains. It’s still reverberating from fallout of the investigation into the Philly Fighting COVID debacle, which led to the ouster of the deputy commissioner who might’ve stepped up in Bettigole’s place. And as the mass vaccination effort continues, public health remains at the forefront of everyday conversation.
The prominence doesn’t seem to faze the 55-year-old, who lives in Mt. Airy and has spent most of her career in public health
“For people who choose to work in city government, you know the things you want to get done will take time and a lot of work,” Bettigole said in an interview.
At her first major press conference last week, she indicated she might not wait to start fixing things. “I have had conversations with leadership of the Medical Examiner’s Office,” Bettigole said, adding that she didn’t intend to interfere with any investigation. “That’s different from looking at policies and procedures and where we need to improve. That is where I see my role.”
After decades at city health clinics and federally qualified health centers, Bettigole joined the city health department in 2015 as director of Philly’s Department of Chronic Disease and Injury Prevention.
A professor at Thomas Jefferson University, where Bettigole earned her medical degree, described her as having a quiet confidence. A former colleague recalled her flexibility, and attention to her under-resourced patients.
“Empathetic is a really good word for her. It flows naturally in her blood,” said Dr. Azizeh Salloum, who worked with her at the New Jersey’s Complete Care Health Network.
Bettigole is not without critics. Most health department employees declined to speak to a reporter, but one former staffer cited a reluctance to break from her former boss or take on risk.
“I have some trepidation around how the city and the health department will bounce back given this opportunity,” said Xavier Lofton, the city’s former health justice fellow, a paid position within the Department of Public Health. “I hope, but I am not hopeful, for substantive change.”
For her part, Bettigole touted first-hand experience with uninsured Philadelphians, and a passion for providing care to people who don’t speak English as a native language.
“The thing about medicine and health, it’s one of the few places where people who can leverage power to make change meet up with people who need change,” Bettigole said.
Helping immigrants and working moms
Growing up in 1970s Buffalo, New York, Bettigole said she was constantly observing her father, who worked as a doctor at the county hospital.
When she was getting her master’s at the University of Chicago, Bettigole studied anthropology. As a student worker, she often overheard the secretary of the department lamenting about getting her six children to a doctor’s office when they were sick.
That’s when she decided to pursue medicine. Bettigole moved to Philly to be with her husband in 1993, and graduated with a medical degree from Jefferson in 1996. After her residency, she worked at two of Philly’s health centers — one at 3rd and Girard, another in the Northeast.
One memory from her time there sticks out. An uninsured patient was sent over from an emergency room for medication. Normally the ER would provide it directly, but since the patient didn’t have insurance, he had to visit a city health center to be able to afford it.
While the patient was waiting to pick up the medicine, he fainted in the parking lot.
“It leaves you with a lot of bitterness. It’s just visceral,” Bettigole said. “When you’re actually crouched on the sidewalk next to someone who is bleeding because the system doesn’t work, you can’t really let go of that.”
James Plumb teaches family and community medicine at Jefferson, and Bettigole was one of his students in med school. He remembers her best for her work at the city health centers — like when she secured permanent funding to hire five language interpreters. The effort, Bettigole said, resulted in a doubling of the number of patients with limited English proficiency who sought medical care there.
“She was really a pioneer, figuring out how to address disparities in immigrant and refugee populations in the Northeast,” Plumb said. “We always would chat about how we might be able to replicate her work.”
After a few years, Bettigole moved on to run the federally qualified health center Complete Care Health Network in New Jersey.
That’s where she hired former colleague Salloum, who remembers applying for the position as a family medicine provider in 2013. Salloum said that because of issues with her newborn, she showed up to the interview an hour and 45 minutes late, sweaty and with breast milk on her shirt. She still got the job, plus was offered a flexible schedule so she could care for her child.
“It was like this female empowerment I needed in my life,” Salloum said. “Like, I could be a working mom. She didn’t question me or make me feel bad about my needs.”
A pay boost, and little sleep
Bettigole returned to city government in 2015, taking over as director of Philly’s Department of Chronic Disease and Injury Prevention, also known as Get Healthy Philly.
Of her work there over the past six years, Bettigole said she’s most proud of tightening regulations for tobacco retailers — which she says contributed to a 20% decrease in density of shops that sell tobacco products. “Smoking is still the number one killer, but no one talks about it anymore,” Bettigole said, adding that Philly still passed rules prohibiting tobacco sales next to schools.
Her move to acting health commissioner a couple weeks ago came with a pay boost. In Bettigole’s previous position, her salary was just above $150,000, according to public records from 2020. She now makes $175,000, per a department spokesperson — more than Farley’s listed salary of $166,250 last year.
Lofton, the former Philly health justice fellow, isn’t thrilled about the new department head. When he read the news that his old boss had been ousted, and why, he was shocked. When he read further and saw Bettigole would be the replacement, he was rattled.
“Once I read her name, that she was the interim, I kind of just had to like, take a beat,” Lofton said, adding that he was “really disappointed.”
It’s unclear whether other current or former employees agree with Lofton, because none would speak to Billy Penn for this story. Some indicated the Department of Public Health had circulated a memo directing staff to avoid speaking with the press.
Lofton remembered a time Get Healthy Philly organized a three-day diversity training, and he said Bettigole only made it to one of the days. In general, he saw her acting as a conduit for Farley’s cautious, bureaucratic style. “There were times I would offer a question of intent or rationale on behalf of our division, and it seemed as if [Bettigole] would always defer to Dr. Farley,” he said.
Bettigole said she doesn’t understand Lofton’s assessment.
“That’s the first time I’ve ever been accused of not wanting to push things forward,” she said. “I absolutely have important work that I would like to do while I’m in this position. … We all have faults. I do not think that’s actually one of mine.”
It remains to be seen how long Bettigole will occupy the office. Mayor Jim Kenney’s administration has not indicated whether she’s being considered for the permanent position.
Does she even want the job? “Honestly I’ve only been doing this for a few days,” Bettigole said. “I’ve barely slept. That question has not entered my head.”