In Search of a Surgeon General

The Ebola crisis highlighted significant gaps in our nation's all-hazards preparedness and the lack of a dedicated, credible public health leader and communicator. The White House appointment of an "Ebola Czar" drew significant bipartisan and public criticism. Embedded within the public outcry of "Who is in charge?" was the repeated question of "Where is the Surgeon General?"

The Surgeon General of the United States is and has been the doctor of the nation. The effectiveness of every Surgeon General is the result of the unique trust that Americans, and the world, hold for the position. That visibility and credibility is entirely based on the necessity that the Surgeon General is a nonpartisan representative of the best that America has to offer. In short, the Surgeon General should be a beacon of hope and fairness whose presence and informative words can calm our nation and the world during a health emergency like HIV or Ebola and educate the public on increasing burdens of preventable chronic diseases.

The U.S. Surgeon General, as a Vice Admiral, is the leader of the only army of health warriors in the world, the United States Public Health Service Commissioned Corps. This mobile force of health professionals is deployable on short notice, anywhere in the world. They are currently serving selflessly today in West Africa and beyond to curtail the Ebola outbreak and provide life-saving care.

As the 17th United States Surgeon General, I had the privilege to represent our nation's best interests in working with all branches of government on a wide array of issues, including the deployment and management of federal emergency response teams. In 2007, Surgeons General Koop, Satcher, and I testified before Congress about the politicization of the Office of the Surgeon General and science. Regardless of whether they served during liberal or conservative administrations, the Surgeons General spoke in unison about the plague of politics. Despite eloquent and truthful testimony, Congress took no action.

In November 2013, Dr. Vivek Murthy was nominated for the position of U.S. Surgeon General. Dr. Murthy is an accomplished doctor very early in his career with no formal public health education or progressive leadership or management experience. He founded Doctors for Obama, later renamed Doctors for America, a partisan group supporting President Obama and his policies. For this reason, the nomination of Dr. Murthy has the appearance of political patronage.

We do not appoint doctors early in their career to be a university Dean or Chairman. Graduate business students at the top of their class don't become instant CEOs. Top law graduates of elite law schools don't get nominated to be the U.S. Attorney General or a Supreme Court Justice. Why would the U.S. Surgeon General be any different? Is the health, safety, and security of the nation any less important? As the 17th Surgeon General of the United States, I know first-hand the experience and skills required to successfully protect scientific truth against the powerful forces at play today in American politics.

Some suggest the National Rifle Association blocked Dr. Murthy's confirmation. However, many Democratic and Republican Senators expressed doubts as to Dr. Murthy's ability to fulfill the role of U.S. Surgeon General. The bottom line is that his Senate confirmation did not proceed because he did not have the votes.

A qualified and rigorously vetted U.S. Surgeon General eliminates the need for an "Ebola Czar" or any other health-related Czar. The U.S. Surgeon General should always be in place and have the authority and skills to coordinate and lead federal resources to protect public health. Without a qualified Surgeon General, we are setting a precedent for rotating partisan "Czars" to manage and coordinate federal responses to all future challenges to our nation.

The public should be outraged by these partisan solutions and the government's failure. The people don't want a Democratic or Republican Surgeon General, just as they don't search for their personal physician by political affiliation. They want the best, most qualified physician to entrust with their health.

The obvious remedy is returning to the tried-and-tested nomination of senior experienced U.S. Public Health Service Commissioned Corps officers for the post of U.S. Surgeon General, just as the Army, Navy, and Air Force continue to do successfully.

Surgeons General inform policy-making based on the best available science. Both political parties should support nominating the most qualified public health physician who merits consideration based on a career that demonstrates progressive management experience and successful leadership of complex public health issues. The job is to protect, promote, and advance the health and safety of our nation and the world. The public we have the privilege to serve deserves no less.