When I heard that President elect Obama was planning to appoint Dr. Sanjay Gupta as the new Surgeon General of the US, I thought it was a great idea.

But apparently, he’s stubbed some partisan toes along the way, and they are planning their revenge.

A couple years ago, iconoclastic filmmaker Michael Moore made a movie Sicko and Dr. Gupta dared to criticize some of Moore’s overblown rhetoric.

I didn’t see the movie myself: I hate “ain’t it awful” type exposes, and although I myself have a lot of criticism of the US health system, my years of service with the IHS makes me leery of those who think a socialist system (such as that Moore lauded) is better.

But apparently an earlier anti Bush film made Moore a favorite of the left wing of the Democratic party, so as a result, Moore’s friends such as Paul Krugman (who also hated Bush)and Senator John Conyers (who wanted to impeach Bush) are planning to try to stop the nomination, claiming:

“It is not in the best interests of the nation to have someone like this who lacks the requisite experience needed to oversee the federal agency that provides crucial health care assistance to some of the poorest and most underserved communities in America,”

Conyers even wants a local Detroit public health doc to be appointed instead.

Bloggers who never worked in an underserved community in their life hyperventillate like this comment:

What in Gupta’s past demonstrates a commitment to (medical care for the disadvantaged)? In addition, has anyone seen the Gupta – Moore debates on Youtube? I say, let’s find a different person. There are too many highly qualified people out there who could do the job.

This is missing the point.

The HHS, not the Surgeon General, is the one who will devise and put into practice any health care reform.

The Surgeon General theoretically is only in charge of the Commissioned Corps of the US Public Health Service, a service corps that once worked with epidemics in ports, and later helped to staff clinics and work on public health projects. Many of them work in the Indian Health Service, as I did in my younger days.

Their jobs are not much different than civilians in these areas, but unlike civilian employees, they can be ordered to work at a different clinic if there is a need for personnel, and they can be called up for emergencies such as Hurricane Katrina.

Once, the USPHS was considered a “military service”, until Jimmy Carter severed the ties and shut down the PHS hospitals that served civilian sailors. When I graduated from medical school, doctors could chose to join the Commissioned Corps rather than the military for their mandatory service. But the history is still there: including the uniform and the paygrade, both based on the Navy.

That is why this blog is absurd to say if appointed he will be an “admiral” without military experience or public health experience, and others will dislike him.

Uh, fellahs, that “Admiral” part is just a pay grade designation.

Again, as for “military experience”, the Surgeon General is a civilian, not military position.

Another criticism is that Dr. Gupta lacks “public health” experience, the same criticism was laid against Dr. Everett Koop, who was a very good Surgeon General under President Reagan.But again this misses the point. All doctors have some public health knowledge. Yet a Ph.D. in public health means doing a lot of number crunching and paper work, which requires different skills altogether from a Surgeon General, whose job is mainly being able to read the dry reports and translate them into pithy English that even a Congressman can understand.

Here is the actual job description:

According to the office’s website, the surgeon general “serves as America’s chief health educator by providing Americans the best scientific information available on how to improve their health and reduce the risk of illness and injury.”

Dr. Gupta worked as a communicator at CNN: providing information to lay people (and remember, most people in the government are “lay people”). So he is qualified for this part of the job.

If Gupta accepts the job, he will be responsible for the Commissioned Corps of the U.S. Public Health Service, which has 6,000 members who work to “protect, promote, and advance the health and safety of our Nation,” according to the surgeon general’s website.

This is the “bureaucrat” part of the job. But again, it is a pure supervisory position, where a lot of the actual work will be done by those under him, allowing Dr. Gupta to make the final decision.

But a lot of the “supervisory”part of the job is getting along with a lot of other people with delicate egos and turf they want to defend.

Again, one suspects that Dr. Gupta probably had run into such problems at CNN.

And the final part of the job description:

The surgeon general will also act as an advisor to the president and the secretary of Health and Human Services.

Again, Dr. Gupta’s “people skills” and “communications skills” are what is needed, and at CNN he has proved his ability to read the complicated medical reports,distill the issue into understandable sentences and then present the story in a pithy manner so that the public, Congress or the President can understand the problem.

So I support Dr. Gupta, and feel his appointment will be a good one for America.


Nancy Reyes is a retired physician living in the rural Philippines. Her website is Finest Kind Clinic and Fishmarket.

She worked as an officer in the Commissioned Corps of the USPHS in her younger days.

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