Shasta County Public Health Officer Dr. James Mu.
Whichever side of the COVID-19 mask/vaccine debate you fall upon, it’s hard not to feel some sympathy for Shasta County Public Health Officer Dr. James Mu. The long-time Shasta County family physician probably never imagined that his cautioning against state and private COVID-19 mandates at a February 2022 Shasta County Board of Supervisors meeting would lead to his appointment as public health officer 20 months later.
His selection in October 2023 was controversial for several reasons.
For starters, the vacancy was created when former Shasta County Public Health Officer Dr. Karen Ramstrom was fired without cause by the Shasta County Board of Supervisors in May 2022. The 3-2 vote featured the board’s new MAGA majority formed after former Shasta County District 2 Supervisor Leonard Moty was recalled and replaced by Tim Garman. Garman, District 4 Supervisor Patrick Jones, and District 5 Supervisor Les Baugh voted to fire Dr. Ramstrom; District 1 Supervisor Joe Chimenti and District 3 Supervisor Mary Rickert voted to keep Ramstrom on the job.
Replacing Dr. Ramstrom during the midst of a pandemic that at the time had killed nearly 600 Shasta County residents was no easy task. After two search committees failed to find any viable candidates for the position, the requirements that the public health officer had to be a licensed medical doctor with a master’s degree in public health were removed. That opened the door for Dr. Mu, who has practiced family medicine in Shasta County for decades but has little experience in the public health field.
After the now-continuous search committee convened last summer, then-chair Jones overruled his fellow committee members who favored an available, better-qualified applicant, and selected Dr. Mu for the position. All seven of Jones’ fellow committee members, including three doctors, rejected Dr. Mu’s appointment due to his inexperience, but Jones placed his hiring on the board’s agenda anyway. One of those committee members, Dr. Nena Perry, objected to Dr. Mu’s outspoken opposition to public health mandates for masks and vaccines and his lack of board certification.
Dr. Nena Perry was critical of Dr. James Mu appointment as public health officer.
“Dr. Mu was well-trained as a family physician, but has minimal training and/or expertise in or with Public Health,” Dr. Perry told A News Café. “I do think, or perhaps hope and pray, that Dr. Mu could do a very good job if he can put aside his personal biases and truly look at what is in the county’s best interest — none of this anti-vax stuff. Public Health is just that: PUBLIC health — and it relies on everyone looking past him/herself to what is best for all of us.”
Dr. Mu completed his undergraduate studies at University of California, Los Angeles, and earned his medical degree at the Medical College of Wisconsin. He completed his Family Medicine Residency training at the Mercy Medical Center and has been practicing family medicine in Shasta County for more than 30 years.
Despite his lack of public health knowledge and experience, last October the MAGA board majority, this time comprised of Jones, District 1 Supervisor Kevin Crye and District 5 Supervisor Chris Kelstrom, voted 3-2 to appoint Dr. Mu as public health officer. Garman and Rickert voted against Dr. Mu’s appointment. Supervisor Rickert noted that Dr. Mu’s contract doesn’t require him to close his family practice or earn a master’s in public health.
Dr. Mu started work with the county on Oct. 23. His contract pays him $106.86 per hour/$18,522 per month/$222,264 per year. In December the MAGA board awarded Dr. Mu a severance package worth up to $333,396. Jones claimed the hefty severance package was a deterrent should a future non-MAGA board attempt to fire Dr. Mu.
The contract permitted Dr. Mu to gradually increase his daily hours as public health officer, from roughly a half-day the first month to a full day over the course of six months. According to timecards, pay records and reports obtained via a public records request from Shasta County, Dr. Mu has met this objective. He’s required to report his progress every six months.
Dr. James Mu at Shasta County Board of Supervisors.
“I am writing to provide you with a current update on my progress with my work action plan as Shasta County’s Public Health Officer,” Dr. Mu said in an email sent to Health and Human Services Director Laura Burch on June 5. “Since May 1, 2024, I have been working full-time at Shasta County Public Health. My onsite hours are from 9:00 a.m. to 5:30 p.m., Monday through Friday.”
“In addition to my public health responsibilities, I am still managing my private practice, though I no longer see patients directly,” Dr. Mu continued. “I visit my office during off-hours, either early in the morning, late in the afternoon, or on some weekends, to ensure that my patients continue to receive quality care from midlevel providers. Occasionally, I attend necessary office meetings as well.”
“We are in the final stages of recruiting a physician to join my private practice. This new physician will eventually take over my practice,” Dr. Mu wrote. “My goal is to have a seamless transition with minimal disruption to my patients in Shasta County.”
Dr. Mu’s contract doesn’t require him to close his practice, but he isn’t allowed to see patients while he’s on duty as public health officer. He is also required to get board certification “from the American Board of Preventive Medicine; or certification by the American Boards of Family Practice, Pediatrics, Obstetrics and Gynecology, or Internal Medicine within two years of appointment.”
“I am currently in the process of regaining my American Board of Family Medicine certification, which I signed up for in September 2023,” Dr. Mu told HSSA Director Burch on April 18. “I am making steady progress toward completing this task.”
However, as Supervisor Rickert suspected, Mu is so far not pursuing a master’s degree in public health.
“Regarding my pursuit of a master’s degree in public health, I have decided to temporarily pause this plan,” Dr. Mu wrote. “My current focus is to dedicate my efforts to my responsibilities as a public health officer.”
It’s been a busy six months for Dr. Mu, whose work routine for the past 30 years has been entirely disrupted. He’s up against a huge learning curve moving from private family practice to public health. Nevertheless, Dr. Mu found the time to respond to A News Café’s questions.
Dr. James Mu at Shasta County Board of Supervisors.
A News Café: You’ve been a family physician for decades. What have been the most difficult things you’ve encountered in your transition from private physician to public health official?
Dr. James Mu: The major difference is transitioning from treating individual patients with whom I had close relationships to focusing on population medicine, which naturally involves some distance. Adjusting to this shift has been a necessary challenge. However, I aim to incorporate a personal touch into the public health realm, ensuring that our policies and interventions reflect the unique needs of individuals within the community.
ANC: When it comes to public health, what do you know now that you didn’t know before becoming Shasta County Public Health Officer?
Dr. Mu: One of the many things I didn’t know before becoming the Shasta County Public Health Officer was the challenges of navigating the county government system. Additionally, I discovered that many of California’s public health officers did not have a public health background when they started their roles. In fact, about 50 percent of these officers do not hold a Master of Public Health degree.
ANC: In your first six-month report on your Action Plan, you note you’ve begun the American Board of Family Practice certification program. How rigorous are you finding the program and when do you expect to complete it?
Dr. Mu: I have been certified and recertified by the American Board of Family Medicine multiple times in the past. However, like many other physicians, I decided not to renew my board recertifications during the last opportunity. The program demands a significant commitment to studying and staying current with the latest medical advancements. I am currently preparing through self-education with steady progression. Balancing the need to achieve recertification with my responsibilities as Shasta County Public Health Officer is challenging, but I am committed to both. I plan to complete the recertification process sometime in 2025.
ANC: In your action plan it says you “may” pursue a master’s degree in public health. In your first six-month report, you say you’ve put this on hold for now as you adapt to the new job. Do you plan to pursue a master’s in public health in the future? In your opinion, does the use of the word “may” in the contract mean pursuing a master’s in public health is optional?
Dr. Mu: My contract with Shasta County is a legal document, and therefore I must follow the legal term ‘may.’ Currently, I have put pursuing a master’s degree in public health on hold. Instead, I am focusing on learning from various publications and available educational opportunities to enhance my knowledge of public health-related topics. Additionally, I aim to reduce the county’s financial burden, especially during a time when budgets from the county and the State of California may need to be adjusted. By prioritizing cost-effective professional development, I can continue to effectively serve the community while being mindful of fiscal constraints. I remain open to the possibility of pursuing a master’s degree in the future, depending on how my role evolves and the needs of the community.
ANC: How close are you from fully transitioning from your private health practice to full-time Public Health Officer? Do you plan to maintain some involvement with your former private practice in the future?
Dr. Mu: I am currently working full-time as the Public Health Officer for Shasta County, as stipulated by my contract. To ensure high-quality medical care for my private practice patients, I also supervise the mid-level medical providers during my off hours, as permitted by my contract. My goal is to eventually hand over a well-managed practice to a future physician who can continue to provide high-quality care in the near future.
ANC: You were given a tremendous number of departments to meet with by June 30, 2024. Here’s the list: PH Deputy Branch Directors, Program Managers, Clinical Nursing Coordinator, Lab Director, and other staff whose programs you interact with regularly or whose programs are of interest to you; Environmental Health Director, Hospital and FQHC Administrators, Emergency Medical Services Director, Regional Disaster Medical Health Specialists, partners recommended to you by staff, and partners you believe it would be beneficial to learn about and/or establish a relationship with. How far have you made it through the list?
Dr. Wu: I have met in person with the vast majority of the managers on this list. Additionally, I have met many wonderful individuals who contribute to maintaining the good health of our county but are not on the list. I plan to continue reaching out to other partners who are important to our county’s health.
ANC: One of your objectives is to read applicable journal articles and other sources of new information related to public health practices. What public health journals or literature are you finding the most informative so far?
Dr. Mu: I have been educating myself on public health through various sources. These include the National Association of County and City Health Officials (NACCHO), the American Journal of Public Health (AJPH), the California Department of Public Health (CDPH), the Health Officers Association of California (HOAC), the Centers for Disease Control and Prevention (CDC), the American Academy of Family Physicians (AAFP), the American Board of Family Medicine (ABFM), and many other online opportunities. These resources have been invaluable in keeping me informed about the latest developments and best practices in public health.
ANC: If we should be presented with a public health crisis equal to or many times worse than COVID, are you concerned that a certain segment of the population will reject public health measures suggested by public health officers, even when those measures are scientifically sound?
Dr. Mu: I am aware that the measures recommended by the Public Health department must be scientifically sound and free from doubts or uncertainties. I understand that some segments of the public may be more skeptical, given their previous experiences with how the California Department of Public Health (CDPH) performed during the COVID-19 pandemic. To address this, we need to steadily gain the public’s trust by consistently exercising tried and true public health measures. Building trust through transparency, clear communication, and evidence-based practices is essential for effective public health response.
ANC: From what you’ve seen so far as Shasta County Public Health Officer, what stands out as the county’s most pressing public health problems?
Dr. Mu: In Shasta County, we face numerous ongoing challenges. These include the prevalence of communicable diseases, chronic diseases, illicit drug use, and opioid-related overdoses. Mental health problems are also a significant concern. Additionally, we are dealing with current and future shortages of healthcare providers. Addressing these issues is crucial for improving the overall health and well-being of our community.
