There are widespread reports out right now suggesting that President-Elect Obama has selected CNN's medical correspondent Dr. Sanjay Gupta has selected to be the new Surgeon General. The reaction to this seems to be mixed. PZ, Orac, Chris, Paul Krugman and Dr. Val are variously unimpressed and/or opposed. Jake is ambivalent. Revere seems to be cautiously optimistic, while both Dr. Pal and Abel Pharmboy are happy. Personally, I'm a little bit more optimistic than cautious.
Some of the reasons that people are concerned about this choice are legitimate. There have been issues that have come up during Gupta's coverage of various issues that are concerning. His coverage of the whole vaccine/autism thing is certainly a prime example. Gupta has said things that sound somewhat sympathetic to the anti-vaccine movement. It's easy to dismiss those as being the end product of the media's propensity for telling both sides of a story - even when there's really only one - but the truth is that we don't really know where Gupta stands, and that's concerning.
Gupta's lack of administrative experience is also a concern. The Public Health service is a a large government bureaucracy. As far as I know, the largest bureaucracy Gupta has had to deal with is CNN's, and the largest one he's been responsible for has been his own little part of that. A good support staff can go a long way toward easing his administrative burdens, but he's still going to have substantial responsibilities in that area. He's clearly a smart guy, and should be able to adjust OK, but he may not. That's also a legitimate concern.
At the same time, there's an issue that's been raised in opposition to Gupta that is much less legitimate. There's also one strong argument in his favor that I don't think has been raised yet. Let's look at those.
On the bad arguments side, let's start with the whole "no military or public health service experience" thing. Dr. Val sources the following remark to an anonymous source:
If Sanjay Gupta is confirmed as Surgeon General he will achieve the immediate rank of admiral, even though he has no previous military or public health experience whatsoever. It will be difficult for Gupta to be taken seriously by peers at the Pentagon and State Department.
Let's start with the Pentagon thing. The Army, Navy, and Air Force all have their own medical departments, each of which is far larger than the 6,000-member PHS Commissioned Corps. They also all have their own Surgeons-General. Gupta's rank, should he be appointed and confirmed, will be the same as the rank of the armed service SGs. The national Surgeon-General is not anywhere remotely near their chain of command, and has absolutely nothing to do with their responsibilities. He's not their superior, and he's not exactly a peer. To be quite honest, I'd be surprised if the military SGs really give a rats ass who gets the job (at least in their professional capacities). As far as the PHS commissioned corps thing goes, I just looked at Surgeon General biographies going back to the Nixon administration. As far as I can tell, only one (Antonia Novello) had prior commissioned corps experience. The Surgeon-General is a political appointment, not a career government service position. Prior PHS experience is the exception, not the rule.
In Gupta's favor, there's an incident back in 2003 when he was reporting on the invasion of Iraq. Gupta was embedded with a Navy medical unit that was providing front-line, MASH-type support for the Marines. I remember one point when I was watching the CNN coverage, and the folks in Atlanta were trying to page Dr. Gupta for a live report from the medical unit. They couldn't get him to do the report at the time. The correspondent that they had sent at great expense to provide coverage from the war zone was scrubbing for surgery.
When the chips were down, he went with his instincts and reacted as a doctor. That, as much as anything else, makes me think that this nomination might just work.
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Well, he's also the Associate Chief of the Neurosurgery Service at Grady Memorial Hospital, which is in essence the second in command. Generally, that means being responsible for the personnel who are involved in neurosurgery there, doctors, nurses, techs, etc. However, I doubt it's more than, at most, a few dozen people, probably more like a couple of dozen.
"The correspondent that they had sent at great expense to provide coverage from the war zone was scrubbing for surgery."
Works for me. Then again, I still can't get over Jocelyn Elders being fired for making a positive remark about masturbation. Let's hope Obama has more courage than Bill Clinton.
The Surgeon General position is important, but of late, it has only been seen as a factotum of Bush-carrying, science-undermining placeholders. I wrote about health policy, professional nursing and patient advocacy for several years, but I was and am still dismissed out of hand. The audacity of a nurse having an informed and legitimate opinion!
Very few progressives read substantive posts about policy and the decimation of government functions and the public well-being.
I wrote specifically about former Surgeon General Rich Carmona and what he offered during Congressional testimony. It was hair-raising, but it didnt garner a ripple from progressives. Carmona has excellent emergency preparedness expertise and experience. He testified that he requested to be sent to New Orleans as a Katrina first responder and that he was denied. Gupta never mentioned that.
Gupta, on the other hand, reports advertiser, commercial pharma crap as unbiased health reportage. He stays to a Wall Street Journal, free market, traditional corporate model of healthcare messaging. He is a commercial sell-out, and he also has many undisclosed conflicts of interest.
Moreover, there is a growing body of evidence that commissioned officers of the USPHS working in the DIHS - the branch that Gupta would be attached to - have been used as agents of abuse and torture on immigrant detainees. The Surgeon General would certainly be obligated to investigate that and report, but no one has. Sec HHS Leavitt has methodically weaponized HHS and used it against the health of the citizenry. DIHS, which was accountable to the USPHS somehow magically migrated to ICA and DHS, and no one is investigating or stopping abusive practices. So not unsurprisingly, people are suffering and dying and no one is doing anything about it.
Gupta has never investigated any Bush/Leavitt/HHS policy or practice. Hes remained silent while the FDA and CDC abdicated their oversight and regulatory responsibilities and imperiled the public safety. For the past eight years, Gupta has never questioned a single thing that the Bush Admin has done.
CNN has even proudly announced that they have repressed all coverage of health policy and health reform since Obama contacted Gupta. The public can not be informed by media who deliberately and willfully withhold vital information.
Carmona would have been a much better pick as he has tons of motive and ability for ferreting out Bush appointee burrowers. He knows the specifics of the science and public health that has been undermined and subverted, and he is passionate about making things right. He also has the support of other former surgeons general.
For an income administration which has generally picked experts for pretty much everything else (economy, science, environment, energy), you really have to wonder about this story.
Is it a fake-out, designed to put the media off the scent? Or have the Obama people just thought that they guy looks good on TV, so he can handle the press conferences? If its the latter, they are going to look very stupid when someone asks what he actually knows about the job in hand - very little by the look of it. He's a TV doctor, not a high-level administrator.
Since the guy is well-known from the spat with Michael Moore to be pretty much against a single payer system, you have to wonder why they would pick him in the first place, which makes me wonder if the story is real at all.