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Paging Dr. Gupta

January 10, 2009

public-health-logo01gifSo, Sanjay Gupta, hm?

Some people in the progressive health care wonk world like the proposed pick of President-elect Obama, some in the, um, Congress don’t particularly like the pick. I take the same stance as my old buddy Revere, I’m not convinced just yet. I think the most important point in this discussion shouldn’t be, “Should Dr. Gupta be the Surgeon General,” but “What does the Surgeon General do anymore?”

Revere loves to play a little game where he asks unsuspecting people who should know better who is the current SG is; by and large, most everyone fails this test, having no idea who the last two or three were. Is the Surgeon General “America’s Doctor,” or has the position become one of leading the USPHS and advocating for and overseeing the publication of reports on public health matters? Given that no one even knows who the current SG is, I would argue the latter of the two.

Today’s health care and public health industry and governmental apparatus have become so big and complex that no one person can oversee them. Sometimes I wonder if the Director of the NIH, Director of the CDC, and HHS Secretary are enough to keep tabs on what’s going on. Increasingly, the Surgeon General is not included in discussions that center around the work of the above names. C’mon, be honest with me, when you read my little list there, you didn’t notice that the Surgeon General wasn’t included, did you?

So, if the Surgeon General isn’t operationally leading anything, what is his or her role? I would argue that the SG is a figurehead position. From the 1964 smoking report to Dr. Koop’s principled stands to Dr. Elder’s masturbation talk, the SG is a communicator, a face in a crisp uniform that hopes to massage the trajectory of public health and health care in the right direction. Wouldn’t someone who reports every day on what’s going on in the health care world be a good person for the job? A face, in a nice crisp uniform, that people trust, and tells them to sneeze into their sleeve? Isn’t that what we’re looking for? Who do you think would be better suited to going on TV and telling people that pandemic flu is coming and here’s what you can do to stop the spread: Dr. Zerhouni, or Dr. Gupta? No disrespect to Dr. Zerhouni, but I don’t see that being his strength.

So, I think I’m leaning towards the idea of Dr. Gupta. It’s out of the box, but I think it might work, given the reality of the Surgeon General’s office these days.

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DRAFT REVIEW UPDATE: Having re-read the above post, I tink I might be coming off a bit harsh on the Office of the Surgeon General. I, by no means, have any intention of belittling the office. In fact, I feel my interpretation of the duties ascribed to the Surgeon General raises the visibility and value of the office.  It’s just that with the change in focus, a change should be made in the skillset required.

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