Most people probably couldn’t name any of our past surgeon generals, with the exception of C. Everett Koop. But with the potential appointment of Dr. Sanjay Gupta, a neurosurgeon and the chief medical reporter for CNN, the position might just get the recognition it deserves. Commonly known as the nation’s doctor, the surgeon general educates the public and pushes forth important public health issues, often butting heads with the president who appointed him or her. While some use the office as a bully pulpit and others quietly compile lengthy reports, most face controversial decisions. In this respect, Dr. Gupta has started early.
I’m the Surgeon General and I’m Here To …
The office of the surgeon general dates back to 1798, when the lead physician of the Marine Hospital Service filled the role. After the hospital service transitioned to the U.S. Public Health Service, the duties of the surgeon general expanded to include national security, disease prevention, disaster preparedness, and health policy.
The surgeon general really acts more like a public health professional, advocating for disease prevention, educating the public, and pushing forward critical health policy issues. They aren’t policy makers per se; instead, they articulate scientifically-based health policy analysis and advice to the president and cabinet ministers.
In addition to representing the health of the nation, the surgeon general also commands the U.S. Public Health Service Commissioned Corps, a relatively small, uniformed personnel who seem to focus more on disaster deployment than national public health. (Even though I have a master’s of public health, I had never heard of this group.) On a daily basis, the surgeon general interfaces with folks from the National Institutes of Health, Centers for Disease Control and Prevention, and other health agencies, both nationally and internationally. He or she also prepares comprehensive reports on topics ranging from tobacco to AIDS, summarizing the scientific evidence with the potential to influence public policy.
Big Initiatives
In the vein of promoting health and stressing the issues that are most salient to the nation during their tenure, many surgeon generals have championed specific causes. For instance, C. Everett Koop, appointed by Reagan, was an outspoken critic of tobacco, calling for “a smoke-free society by the year 2000.” But Koop is perhaps best known for his leadership on HIV and AIDS, which became an important issue during his time in office. His approach was informational and nonjudgmental and he helped make AIDS a public health issue rather than a moral one.
