Diagnosis for Democracy
Insights into the State of Our Union
A Blog by Rob Tenery, MD


April 21, 2014: The Surgeon General--- Where’s the Beef?

By Rob Tenery, MD on April 21, 2014

The President’s nomination of Vivek H. Murthy, M.D. for the office of Surgeon General reveals how the current administration selects individuals to help run this country. Past Presidents have not always supported the most qualified candidate for a particular position, but one who more closely aligns with their particular point-of-view. Recently, the nomination of Dr. Murthy, a Harvard College, Yale Medical School graduate and residency trained Internist at the Brigham and Women’s Hospital in Boston, has drawn both praises and criticism from differing sectors of the community.

Often referred to as ‘the Nation’s Doctor’, the Surgeon General is the operational head of the U.S. Public Health Service. The person who holds that position is also the leading spokesman on public health matters in the federal government.

After completing his residency in 2006, Dr. Murthy joined the faculty of Brigham and Woman’s Hospital as a Hospitalist and Instructor in Medicine at Harvard Medical School. Despite his pristine academic credentials, it is his activities outside direct patient care that appear to have garnered him the President’s nomination for Surgeon General.

Dr. Murthy’s career in advocacy began when he co-founded and served as president of Visions Worldwide in 1995. It was an organization that concentrated on AIDS education and prevention in the U.S. and India, the homeland of his parents. He went on to co-found TrialNetworks, a cloud-based optimization system that would allow clinical trials to bring new drugs to the market more quickly and safely. In 2008, he started Epernicus, a collaborative networking platform for scientists to improve their research productivity. In that same year, he co-founded Doctors For Obama, which was later renamed Doctors for America, where he served as the national chairman. In 2011, Dr. Murthy was appointed by President Obama to the U.S. Presidential Advisory Council on Prevention, Health Promotion, and Integrative and Public Health within the HHS.

Outside of the medical community, the most controversy with Dr. Murthy’s nomination comes from the supporters of the ‘right to bear arms’. Contained in a Twitter posting in October 2012, the nominee wrote, “Guns are a health care issue.”  With his support for Obamacare (the ACA) and apparently gun control, two of the most controversial domestic issues being pushed by our President, Dr. Murthy’s nomination comes as no surprise.

His academic credentials and interests in improving world health and medical research are laudable. However, the major concerns, voiced by some members of the medical community, are based on Dr. Murthy’s lack of clinical experience--- being exposed to and responsible for direct patient care. The experience of titrating oxygen levels in an elderly patient with advanced emphysema or getting up in the middle of the night to comfort a family member who has just lost a loved one to a terminal disease. These are the kind of experiences that earns one the right to be called ‘the Nation’s doctor’.

Even though the main responsibility of the Surgeon General is to be the spokesman for public health and disease prevention, Dr. Murthy’s two plus year tenure on the President’s Council on public health and his early participation in AIDS awareness give him only minimal credentials in this area.

Dr. Murthy’s expertise is in political advocacy, not patient care. He is an idealist, much like our President. Although he should be commended for his medical training and activism, these do not automatically translate into being a good doctor. That comes from ‘being there’!

If he becomes Secretary General, Dr. Murthy rounds out three of the most important members of President Obama’s healthcare team: Ezekiel Emanuel, M.D., PhD, purported to be the leading architect of the Obama care legislation, stayed in academic medicine and held the position as associate professor at Harvard Medical School. Upon entering the public sector, he joined the National Institutes of Health where he was Chief of the Department of Bioethics. Currently, he holds the position of Special Advisor for Health Policy to Peter Orszag, the Director of the Office of Management and Budget. Although she has announced her retirement, current secretary of Health and Human Services, Kathleen Sebelius’ credentials are a B.A. in political science, a Master’s degree in Public Administration, former Governor of Kansas and former lobbyist for the Kansas Trial Lawyers Association.

With these three individuals, that have helped to create, are in charge of implementing and will act as spokespersons for President Obama’s agenda to transform this country’s health care delivery system, there seems to be a pattern--- a pattern of exemplary credentials, passionate idealism of what should be, but very little experience in the ‘trenches’ of actual health care delivery--- one that appears to closely follow the path of President Obama himself.

The often-quoted line, first appearing in an advertising campaign for a national hamburger chain, seems to succinctly wrap up the concerns of many members in the medical community about the President’s health care team--- Where’s the beef?

This country deserves better!




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