The White House announced on Nov. 14 that President Obama would nominate Dr. Vivek Murthy for Senate confirmation as the next US surgeon general. Murthy is a young physician with a distinguished career. But unlike other recent nominations, including those for leadership of Department of Homeland Security and the Federal Reserve, his selection has barely registered on the national stage. He didn’t get a televised ceremony at the White House. His nomination was announced with an end-of-day press release. It slipped past most Americans; the public was mostly unaware of the last surgeon general (Dr. Regina Benjamin) or the fact she had even left.
Murthy’s inconspicuous nomination reflects the declining influence of the post he may soon assume. The surgeon general has historically been, and needs to be, an independent medical voice on public health, rather than an arm of the administration’s health policy. Yet, in recent years, the public presence of the surgeon general has all but disappeared. One could argue many reasons for this deterioration, from failed nominations under recent administrations to prolonged periods without an official surgeon general to consolidation of power under the Secretary of Health and Human Services. While all of these factors undoubtedly play some part, the politicization of the position seems to be a leading contributor.
In 2007, three former surgeons general — Richard Carmona, C. Everett Koop, and David Satcher — came together for a congressional hearing on the challenges of the office. Their testimonies were astounding. During Carmona’s tenure in George W. Bush’s administration, senior officials instructed him to mention Bush’s name at least three times on every page in speeches, and prevented or delayed many of his reports for political purposes. While the Reagan White House tried to keep Koop silent on the growing AIDS crisis, the Clinton administration blocked Satcher from releasing reports on needle exchanges and sexual health education.
It was quite a sad reunion. Surgeons general from the 1980s, 1990s, and 2000s, each attesting to political manipulation and the stifling of scientific findings that could otherwise improve our public health.
So, how does Murthy fit into this backdrop? At 36, he has accomplished more than his age would suggest. Murthy has founded several organizations, including the nonprofit VISIONS Worldwide dedicated to HIV/AIDS education and the software company TrialNetworks that seeks to improve the efficiency of drug development and clinical trials. He has served on the surgeon general’s Prevention Advisory Group, a panel of appointees created by the Affordable Care Act to develop recommendations for public health promotion. In addition, he is a practicing physician at Boston’s Brigham and Women’s Hospital and an instructor in medicine at Harvard.
However, he is best known as the cofounder of Doctors for America — a national grass-roots organization of over 16,000 physicians and medical students advocating for improvements to our health care system. Whether filing amicus briefs to the Supreme Court or contacting representatives in Congress, the organization has spent much of its time lobbying for the Affordable Care Act, which may be a point of contention during Murthy’s confirmation hearings.
Of course, to be involved in health care without thoughts on the Affordable Care Act is to not to be involved in health care at all. And, once in office, the surgeon general should have the authority to educate the public about accessing health care, regardless of the optics. But Murthy’s advocacy speaks to a broader problem — on the whole, his eligibility for the post seems to come from his political, rather than professional, contributions.
Doctors for America originally began as Doctors for Obama, which campaigned on the president’s behalf in 2008. What’s more, Murthy served on Obama’s New England steering committee in that election and as a volunteer adviser to the president’s reelection team in 2012. In an op-ed last week for USA Today, Dr. Bruce Davidson even suggested that Murthy’s appointment to the Prevention Advisory Group was simply tribute for his prior political support.
For a position that requires nonpartisan scientific analysis for advancing the nation’s health, these credentials are troubling to say the least.
Murthy could still be a strong surgeon general. If confirmed, he would bring a bevy of qualities to enhance the role, including youth, health policy insights, and an inventive background. Yet his considerably partisan resume raises questions about his potential independence in the position. Specifically, should a leading figure of Doctors for Obama, which became Doctors for America, become America’s doctor under President Obama?