Yesterday, President Obama announced his choice for the Surgeon General post: Regina Benjamin, a family doctor who built and repeatedly rebuilt a rural health clinic in Bayou La Batre, Alabama. She was the first African-American woman to be named to the American Medical Association's Board of Trustees, became President of Alabama's State Medical Association in 2002, and was named a MacArthur Fellow in 2008. In his remarks, though, Obama explained that itâs Benjaminâs experience delivering care in an underserved area that makes her such an appropriate choice at this particular moment:
For nearly two decades, Dr. Regina Benjamin has seen in a very personal way what is broken about our health care system.Â She's seen an increasing number of patients who've had health insurance their entire lives suddenly lose it because they lost their jobs or because it's simply become too expensive.Â She's been a relentless promoter of prevention and wellness programs, having treated too many costly and -- diseases and complications that didn't have to happen.Â And she's witnessed the shortage of primary care physicians in the rural and underserved areas where she works.
But for all that she's seen and all the tremendous obstacles that she has overcome, Regina Benjamin also represents what's best about health care in America -- doctors and nurses who give and care and sacrifice for the sake of their patients; those Americans who would do anything to heal a fellow citizen. Through floods and fires and severe want, Regina Benjamin has refused to give up.Â Her patients have refused to give up.Â And when we were talking in the Oval Office, she said:Â The one thing I want to do is make sure that this Surgeon General's Office gives voice to patients, that patients have a seat at the table; somebody is advocating for them and speaking for them.
Because the Surgeon Generalâs chief function is to use the bully pulpit to advance the administrationâs health priorities, itâs telling that Obama chose a Surgeon General who will presumably advocate for improving healthcare access for those who are underserved. I expect weâll see her in the news promoting the mechanisms Congress chooses for making insurance more widely available and affordable (those mechanisms could include a public plan, a health insurance exchange, a Medicaid expansion, and premium subsidies).
Thereâs another part of her biography I hope will also inform improvements to our healthcare system. Benjamin started practicing medicine in Alabama as part of the National Health Service Corps, a program that provides scholarships and loan repayments to primary-care clinicians who agree to serve in Health Professional Shortage Areas for two to four years. This program is a great way to address the shortage of primary-care doctors in medically underserved area â a shortage that will become even more apparent if we succeed in expanding healthcare coverage to people who currently lack it. According to the NHSC, 80% of their clinicians stay in the underserved area after their time commitment is up, as Benjamin did.
I look forward to having a Surgeon General who will push for healthcare access, with an emphasis on prevention, for all.
What do you think of some of the comments & criticisms that she doesn't have a public health background? (I'm pretty sure I've just seen this statement in the comments after articles in the Wash Post, NYTimes, etc.--haven't seen any public health bloggers comment on it, or seen any quotes actually in a news analysis.)
I'm not worried about her direct public health experience. She has represented the needs of public health very well in her professional life. In addition, she is well versed on the heath issues and challenges facing society today. Her background in organizational leadership (State Medical Society and others) and her service as Chairperson of the AMA's Council on Ethical and Judicial Affairs well prepares her for this next roll.
Yeah, I think if she's promoting prevention and better access to healthcare, then public health folks will be happy with her.
I don't know enough about past Surgeons General to say whether it's common for them to have significant public health experience before being appointed, but I suspect many of them don't. From C. Everett Koop's HHS bio, it looks like he was a surgeon with little (if any) public health experience when he took the job - but as Surgeon General, he did a lot to curb smoking, which is a major public health achievement.