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opinion | Nathaniel P. Morris

A strong leader needed for top US doctor

Outgoing surgeon general Regina Benjamin encouraged healthy lifestyles during her tenure.

Associated Press/File 2009

Outgoing surgeon general Regina Benjamin encouraged healthy lifestyles during her tenure.

On June 12, Dr. Regina Benjamin announced that she would be stepping down as surgeon general. She is certainly an inspiring figure. Hailed as a hero in the world of primary care, Benjamin founded a rural clinic in Alabama that she famously rebuilt on multiple occasions — once after Hurricane Georges, then after Hurricane Katrina, and again after a fire. She was the first African-American woman elected to the American Medical Association Board of Trustees. In addition, she won the Nelson Mandela Award for Health and Human Rights and a MacArthur “genius” award. This impressive resume made her an obvious choice for nomination by President Obama.

During her tenure as surgeon general, Benjamin translated much of her previous experience into her work. She encouraged preventive care and healthy lifestyles to combat the onslaught of chronic illness in our country. Obesity was the central target of her efforts; whether organizing walks or visiting schools during lunchtime, she took a stand against what may be the defining health issue of our time. Upon the announcement of Benjamin’s resignation, influential voices like Health and Human Services Secretary Kathleen Sebelius and the American Public Health Association praised her service.

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However, in many important ways, she did not fulfill the job. She avoided the spotlight and concentrated on the agreeable issues of diet and exercise. Her office remained practically silent during the prolonged fight over the Affordable Care Act and, as of recently, roughly half of Americans still do not understand the law. Critics have referred to her as “virtually invisible” and “nowhere to be found.” The most newsworthy moment of her term was the political controversy over her own weight and whether it disqualified her from performing her duties.

These criticisms are not to say that the job is easy — surgeon generals must balance dozens of competing interests and the White House often censors the ideas coming out of that office. Yet prior appointees have managed to make groundbreaking contributions, whether stunning the public with the dangers of smoking or educating households about the AIDS epidemic. Benjamin chose instead to go under the radar. And when “America’s doctor” keeps a low profile, we have lost our chief advocate for public health.

Now is a time of great turmoil in health care and the larger scientific community, and Obama should consider this as he selects the next surgeon general. Whoever takes the torch from Benjamin will face difficult circumstances, ranging from a sick, overweight, and aging population to a broken health care system. In tackling these problems, her successor should elevate the position from one of near obscurity to one of daily relevance.

America needs a surgeon general who guides our national discussion beyond the simple idea that vegetables are good for you. From this bully pulpit, our surgeon general could stand up in unequivocal defense of stem cells and their promise to transform the future of human medicine. Our leading physician could recognize that cancer patients should be able to use medical marijuana to ease pain in their dying days. This public figure might call out Congress for subsidizing the cheap, caloric food that is fueling obesity across our nation. We need a surgeon general who stirs some controversy in order to move our country forward.

These actions require a measure of independence from the daily politics of the White House. After all, the president already has a Health and Human Services secretary to set the administration’s policy on health issues. What’s needed is a figure of independent stature whose word is credible precisely because he or she operates largely outside the realm of politics.

Our next surgeon general should join the ranks of other powerful appointees who change America from within their respective fields. For example, Ben Bernanke, chairman of the Federal Reserve, shapes the way in which we do business; and John Roberts, chief justice of the Supreme Court, sways the manner in which we understand our laws. The surgeon general has nothing like their authority, or their unique policy-making platforms. But nor should the surgeon general sit idly under the thumb of presidential direction, clearing statements and waiting for orders. America’s doctor should influence national health policy on a significant level, a level that pushes the limits of scientific inquiry and forces us to confront the complex medical questions that rattle our country. In sum, America’s doctor should lead.

Nathaniel P. Morris is a student at Harvard Medical School.
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