Tuesday, July 10, 2007
Doctor of a Nation or Doctor of a Political Party: Duty of the U.S. Surgeon
General
From today's Los Angeles Times:

President Bush's first surgeon general charged today that administration
officials prevented him from providing the public with accurate scientific
and medical information on such issues as stem cell research and teen
pregnancy.

"The reality is that the 'nation's doctor' has been marginalized and
relegated to a position with no independent budget and with supervisors who
are political appointees with partisan agendas," Dr. Richard H. Carmona told
the House Committee on Oversight and Government Reform. "Anything that
doesn't fit into the political appointees' ideological, theological or
political agenda is ignored, marginalized or simply buried.

"The problem with this approach is that in public health, as in a democracy,
there is nothing worse than ignoring science or marginalizing the voice of
science for reasons driven by changing political winds," said Carmona, who
served from 2002 to 2006. "The job of surgeon general is to be the doctor of
the nation - not the doctor of a political party."

So, who is the Surgeon General and what is his or her duties? Here is some
background information from Wikipedia:

The Surgeon General of the United States is the head of the United States
Public Health Service Commissioned Corps and, ex officio, is the leading
spokesperson on matters of public health in the U.S. government. The Surgeon
General is nominated by the U.S. President and confirmed via majority vote
by the Senate. The Surgeon General serves a four year term of office and is
commissioned as a Vice Admiral in the PHSCC. [1] In carrying out all
responsibilities, the Surgeon General reports to the Assistant Secretary for
Health, who is the principal advisor to the Secretary of Health and Human
Services on public health and scientific issues, and who serves as the
overall head of the United States Public Health Service. The former Surgeon
General, Vice Admiral Richard Carmona, appointed by President George W. Bush
in 2002, left office when his term expired on July 31, 2006. [2]. Rear
Admiral Kenneth P. Moritsugu is functioning as the Acting Surgeon General.
[3].

On May 24, 2007, President Bush nominated Dr. James W. Holsinger, Jr., a
University of Kentucky medical professor to be the 18th surgeon general of
the United States. [4]

The Surgeon General functions under the direction of the Assistant Secretary
for Health and operationally heads the 6,000-member Commissioned Corps of
the United States Public Health Service, a cadre of health professionals who
are on call 24 hours a day, and can be dispatched by the Secretary of HHS or
the Assistant Secretary for Health in the event of a public health
emergency. The Surgeon General is also the ultimate award authority for
several public health awards and decorations, the highest of which that can
be directly awarded is the Surgeon General's Medal (the highest award
bestowed by board action is the Distinguished Service Medal).

The Surgeon General also has many informal duties, such as educating the
American public about health issues and advocating healthy lifestyle
choices.

The office also periodically issues health warnings. Perhaps the best known
example of this is the Surgeon General's Warning labels that can be found on
all packages of American cigarettes. A health warning also appears on
alcoholic beverages.

Past American Surgeons General have often been characterized by their
outspoken personalities and often controversial proposals on how to reform
the U.S. health system. Because the office is not a particularly powerful
one, and has little direct impact on policy-making, Surgeons General are
often vocal advocates of unconventional, unusual, or even unpopular health
policies. Vice Admiral C. Everett Koop and Vice Admiral Joycelyn Elders were
two former Surgeons General who were well known for their controversial
ideas, especially on sex education.

The U.S. Public Health Service was under the direction of the Office of the
Surgeon General and was an independent government agency until 1953 at which
point it was integrated into the United States Department of Health,
Education and Welfare, and later into the United States Department of Health
and Human Services. Although the U.S. Public Health Service and the Surgeon
General were at various times under the umbrella of the Department of the
Treasury or the Federal Security Agency, the agency operated with a
substantial amount of independence.

The U.S. Army, Navy, and Air Force also have officers overseeing medical
matters in their respective services who hold the title Surgeon General.

In Republic of Ireland and United Kingdom, the term chief medical officer is
used as equivalent.

Service rank
The Surgeon General holds the rank of Vice Admiral [5] in the Public Health
Service Commissioned Corps, one of the seven Uniformed services of the
United States. Officers of the PHSCC and the National Oceanic and
Atmospheric Administration Commissioned Corps are classified as
non-combatants, but can fall under the uniform code of military justice
(UCMJ) and the Geneva Convention when designated by the Commander in Chief
as a military force. Officers Members of these services wear uniforms that
are similar to those worn by the U.S. Navy, except that the commissioning
devices, buttons, and insignia are unique. Officers in PHS and NOAA wear
unique devices which are similar to U.S. Navy Staffing Corps Officers (e.g.,
Medical Services Corps, Supply Corps, etc.)


Though in today's Congressional hearings where Dr. Carmona and two previous
Surgeon General's told their story of political pressures being applied to
the Surgeon General during the current and previous administrations, it was
brought out that Carmona in the current administration was under the most
pressure. It is interesting to find that President Bush who has made much of
the fact that he was depending and listening to the views of the "generals
on the ground" would seem to avoid listening to his Surgeon General about
the science regarding stem cell research and teen pregnancy and stick to his
political ideology. ..Maurice.
posted by Maurice Bernstein, M.D. @ 8:24:00 PM

Rayilyn Brown
Board Member AZNPF
Arizona Chapter National Parkinson's Foundation
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