America’s doctor
The next U.S. surgeon general should be allowed to better use the bully pulpit.
Give the next U.S. surgeon general a giant megaphone and let him or her use the bully pulpit to be America’s doctor.
That role — preferably conferred on a physician who can make public pronouncements about health matters whether they are politically popular or not — is needed now more than ever to illuminate the nation’s looming health threats. History, in part, shows us the way.
Fifty-three years ago, U.S. Surgeon General Luther L. Terry issued a report that hit the country like a bombshell. The report linked smoking to lung cancer and bronchitis and ushered in a new era in U.S. policy on tobacco.
Less than 20 years later, another surgeon general, C. Everett Koop, made his mark as America’s doctor from ’81 to ’89 with his blunt talk about the AIDS epidemic.
With the recent departure of U.S. Surgeon General Vivek H. Murthy, an Obama administration holdover who was asked to resign by the Trump administration, his replacement should be cast in 21st century molds of Terry and Koop, both of whom were independent voices who spoke truth to the public and to power.
Terry was truthful with President John F. Kennedy about smoking dangers, and Koop was straightforward with President Ronald Reagan about raising awareness about AIDS, then a new disease. In the age of Donald Trump, the country needs a singular expert voice that can connect with people across the media landscape, make public appearances and provide accurate information.
The post of U.S. surgeon general remains relevant nearly 150 years after the first appointment. But times have changed. Michael Stobbe, an Associated Press medical writer, in his 2008 scholarly work on surgeons general wrote: “The ability of the Surgeons General to use the bully pulpit has been affected by political meddling, resource constraints and — some would argue — the selection of sub-optimal people for the job.”
Since 1968, the position has had little power beyond the ability to call attention to serious public health problems and other data and solutions. He or she oversees the U.S. Public Health Service Commissioned Corps’ 6,700 uniformed public health care personal who work in various parts of the federal government. However, in recent years the surgeon general’s voice has often seemed muted during major health crises, and no one has taken notice more than Dr. Peter Hotez, founding dean of the National School of Tropical Medicine at Baylor College of Medicine.
When it came to H1N1 (swine flu) pandemic in 2009, the Ebola outbreak in 2014 and the Zika epidemic last year in Florida, the surgeon general seemed conspicuous by his absence. Most of the information was coming from the White House or a U.S. Centers for Disease Control and Prevention spokesman.
“We have not had strong public health communication messaging that is consistence and reliable,’’ Hotez said.
It doesn’t have to be that way. President Trump should re-evaluate the U.S. surgeon general post. We suggest he then nominate a doctor whom he will allow to speak candidly about such issues as the need for action to combat infectious diseases, especially along the Gulf Coast, and the anti-vaccine movement that spreads false and misleading information.
History has shown that allowing an independent approach to the job can be fraught with controversy. For example, Joycelyn Elders, an inspirational public speaker who served from ’93 to ’94 during the Clinton administration, spoke out forcefully about teen sex and teen pregnancy among other controversial topics. She lasted less than 15 months before Clinton asked her to step down.
That’s the challenge with bully pulpits; One steps into them, and more often than not, one unexpectedly has to step down. But the message that’s sent forth has an opportunity to leave a deep impression.