Thursday, January 8, 2009

Idle Thoughts

Off the top of my head -- and from where else does most of this stuff come? -- I find the idea of Sanjay Gupta as Surgeon General puzzling. I say this as a physician, and as a medical school classmate of a recent Surgeon General. One thing the two have in common is that I contacted (or tried to) each of them seeking endorsement blurbs for my book. Dave kindly and thoughtfully demurred. In seeking out Sanjay, I discovered there are at least two Dr Sanjay Guptas, a fact which I could have shared with a few internet bloggers and saved them some embarrassment. But I digress.

I think Sanjay Gupta and I are approximately equally qualified to be Surgeon General, other than the fact that I'm more experienced. We are both surgeons. Let's assume he's as good at his branch, neurosurgery, as I was at mine, even if he has many fewer years under his belt than I. Certainly, he's much more well-known; but really, it's only a matter of degree in a field that otherwise is pretty comparable: we each participate in media as a way of imparting knowledge and opinion in the field of medicine. Other than the fact that his is TV and mine is the blogosphere (I'm referring, of course, to my other blog), it's of a piece. I don't claim his level of fame, obviously, nor of influence. But there was a time when my writing was getting a bit of mainstream notice, having been mentioned in the New York Times, the LA Times, the Chicago Sun Times (what is it about "times?") and, egad, even Foxnewsdotcom. So what's the difference, curriculum vitally?

As far as I can tell, the Surgeon General has two roles. One, which would seem potentially quite important and demanding, is the as highest official in the Public Health Service Commissioned Corps. Theoretically, this would require knowledge of public health issues and policy, and some management experience. On the other hand, the PHSCC is not to be confused with the Public Health Service, a much bigger deal, under which the PHSCC serves. The critical letter in PHSCC is the first "C." The outfit is, formally, like a branch of the military: they wear uniforms like Navy people, and the Surgeon General is ranked as a three-star admiral. They all run around doing stuff, but they aren't the ones actually setting public health policy.

Unlike Sanjay G, I was in the military, which gives me leg up. In fact, "Surgeon" was part of my official title. "Flight Surgeon." Part of my duty was, in fact, as public health officer for the bases on which I served. Fortunately, someone else took care of it -- the veterinarian, as I recall -- but it was on my list of things to do. So there's two legs up.

I'm guessing there are lifers who actually run the show. So the Surgeon General is more about the other role, namely being a public face on health care issues. Some have made a name for themselves in that regard. Luther Terry, most positively, got the labels on the cigarettes. C. Everett Koop helps people who've fallen and can't get up. Joycelyn Elders tried to help people who did get it up.

Clearly S. Goop has little to bring to the table policy-wise, but he could be seen as a skillful conveyor of information to the public. That's what I assume is behind the idea: a weapon in the arsenal to be used to sell Obama's health care plans to the public. If the PHSCC is like other bureaucracies that seem to run on no matter who's at the top, I suppose it makes some sort of sense.

But he should have chosen me.



Gia's Spot said...

You have my vote!

Anonymous said...

Jeez Sid, I haven't heard as many Sour Grapes since Sonny dumped Cher...only 2 Dr. Sanjay Guptas? Come to Atlanta, we gotta whole 2Yellow Pages Full, and thats just the Nephrologists.... And I guess, the "Air Force" does count as Military, at least my dad says it is, even if they change their uniform styles more often than Madonna changes Hairstyles...Admit it!! Thats why you're really upset, you just want that cool Navy Uniform....

dodge said...

You can be Surgeon General only if it doesn't interfere with keeping up your blog, young man.

Your Mother

Anonymous said...

Well, he fits right in with the new administration. Obama--no executive experience. Clinton, no foreign policy experience (unless you count her husband cashing those Saudi checks). Panetta, no intelligence experience.

Add in Caroline, darling of the Democrats. No work experience whatsoever.

Pretty slick new incoming government, I'd say.

OHN said...

But Dr. S....he has to be the best choice. After all, when I am sitting in the office waiting room, he is on TV explaining why I shouldn't add salt to my eggs that I shouldn't be eating.

Sid Schwab said...

Right on cue, anon. And, as usual, reflexively vacuous. How 'bout this: come back after they've been in office for a few months.

MargaretWV said...

I hope this choice is about selling health care reform to the American public because it is rather puzzling otherwise.

I wonder if Obama is a bit star-struck at times. The choices of Rick Warren and Sanjay Gupta make a bit more sense, in that context.

Margaret, armchair psychologist

Sili said...

Poor Jocelyn.

Well, Phil Plait's running for NASA admin.

"Bloggers for Office" wouldn't be the worst of causes.

Anonymous said...

"reflexively vacuous"

Uh...Sid, this is your criticism of The One. I'm just trying to support the new president. Maybe after a few months you'll be happier with the latest celeb in government.

Sid Schwab said...

Uh, anon: I'm able to criticize people with whom I agree on other matters. And see positives in those with whom I disagree. How about you?

Annie said...

Coming out of lurk mode. There is a growing body of evidence that the USPHS nurses and physicians who were detailed to the DIHS (which magically "migrated" to ICE and DHS - but without any congressional health mission charge) were used as agents of abuse and torture of immigrant detainees. Gupta never mentioned this, even though it was a week long investigatory reporting series by Dana Priest and Anne Goldstein the WaPo.

Gupta's home base is Atlanta, not coincidentally, also home of the CDC and Julie Gerberding who decimated the organization and morale of career physicians and scientists there (she was just given the boot by Obama this past Friday). Gupta? Lips were sealed.

At his hospital, Andrew Agwunobi spent a whirlwind year as CEO wunderkind, only to go to Florida and WellCare, where he and Jeb Bush are under investigation for Medicaid fraud.

Gupta? Not a whisper.

He has multiple undisclosed conflicts of interest with financial relationships with several bigPharmas. Nary a word on his CNN web bio.

The most recent Surgeon General, Dr. Rich Carmona, testified last summer that he is an emergency preparedness expert (and a board certified trauma surgeon, so he's not a shy and retiring type) who asked and was refused permission to serve as a first responder in New Orleans.

Gupta? Blackout on CNN of the week-long CSPAN testimony, in which Waxman and Kennedy followed up with a demand to create legislation to make the SG role independent and not subversive to the HHS Sec - out old abstinence only, follow your conscience/damn the healthcare Leavitt.

Not for nuthin', I blogged all of that and more last year, and no one came to my blog party.

Dr. Schwab - you wannan run at this, I say go for it. The way they vetted Richardson (snort), they'd love to have you, I'm sure.

You'd be much better than Andrew Agwunobi's brother, John, who as a Asst HHS secretary rank of Admiral, wearing that lovely admiral braid, gave wrong and misleading pandemic flu preparation information on a sham HHS blog actually run by the PR firm Ogilvy (your tax dollars at work) for leavitt, he fled directly to Wal-Mart where he is now the director of health and wellness. (snort again - except that's really a gasp and wheeze from the H5N1 virus coming your way)

And don't get me started on Gupta's stance on the antivaccination crowd (he gives them credit for a legitimate argument) and the FDA's gutting while undermining regulations and science and imperiling the safety of the nation (Chinese toys, food, salmonella surprise at your local restaurant, everyone?)

He is on record about one thing_ he's against universal healthcare and single payer. Yea team.

I couldn't make this stuff up. I don't have the imagination required.

Happy New Year. Yes, (we) the top 2% can.

Sid Schwab said...

annie: thanks for a comprehensive and provocative commentary, about much of which I wasn't fully aware. (Carmona, who did his surgery training where I did, impressed me when he came out with all the pressure that had been put on him to conform his speeches tow White House criteria, including -- but hardly limited to -- mentioning George Bush at least three times per page.)

About one thing you might be wrong, unless you're referring to other info: as in the first link in my post, it seems some of the stuff about Gupta's conflicts vis a vis drug companies turned out to be related to another doc with the same name.

Even so, it's pretty strong stuff!

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