Obama's choice of Sanjay Gupta as Surgeon General (part 2)

by: los anjalis

Tue Jan 13, 2009 at 23:55:19 PM PST

In my previous post, I quoted the website of the Surgeon General's office for the job's description.  Since that post, Dr Val Jones conducted an excellent and timely interview with Dr Richard Carmona, a physician who served in the position of Surgeon General from 2002-2006 (and disagreed strongly with the Bush administration on many issues).  You can listen to the interview or read the transcript.  An excerpt:

Dr. Val: What does the Surgeon General do on a daily basis?

Dr. Carmona: The Surgeon General is the commander of the US Public Health Service Commissioned Corps, which consists of thousands of officers in hundreds of locations around the world working anonymously to keep our nation and our world safe. The Surgeon General interfaces on a daily basis with the NIH, CDC, SAMHSA, HRSA, and all of the federally related health agencies as well as global health organizations like the World Health Organization, Pan American Health Association, and the American Public Health Association. The Surgeon General provides in-depth analysis of health policy for every cabinet minister, including the Interior, Commerce, and Homeland Security. It's a very visible, credible, and iconic position.

I won't belabor this point, but Dr Gupta is a well respected neurosurgeon but still a neurosurgeon (not a public health or primary care physician) and has one year's experience working as a White House Fellow with then First Lady Hillary Clinton on healthcare issues.  Previous surgeons general have essentially been those with years of experience in the public health corps or in the field of evidence-based public health.

Dr. Val: What should Americans expect of their Surgeon General?

Dr. Carmona: The Surgeon General of the United States needs to remain a non-partisan physician. He or she should always communicate the honest, scientific truth to the American public so that they can make informed decisions about improving their health. Often, that scientific information is not the same as the policy that the President or Congress come out with, because policy is a very complicated process.

The Surgeon General has the largest medical practice in the nation (300 million), and when he or she issues reports, they actually change behavior in our country and the world. The Surgeon General is the true, honest broker of the best science for the people, offered in an a-political fashion. He or she is a patient advocate at the very highest level of government, and is expected to address the most complex health problems that face our nation. There is no more important or influential office that an American physician can hold.

Dr Carmona brings up some important points here.  The Surgeon General MUST be apolitical, and must have the ability to go against the President or Congress in favor of the honest, evidence-based findings on public health issues.  Dr C Everett Koop and Dr Jocelyn Elders stand out as surgeons general who accomplished these things, whether controversial at the time or not.  Which brings me to qualifications and causes for concern.  Many people share the following concerns about Dr Sanjay Gupta:

Concern #1: Numerous visible conflicts of interest, tarnishing Dr Gupta's credibility.

This is huge.  Dr. Gupta has no lack of conflicts of interest.  As said so well by Gary Schwitzer, Professor of Journalism and Mass Communication and blogger at Schwitzer Health News Blog, "Usually where there's smoke, there's fire".  

(Click on "There's More" for the remainder of the post)

Obama chooses "shiny" Sanjay Gupta as Surgeon General

by: los anjalis

Tue Jan 06, 2009 at 14:35:26 PM PST

Dr Gupta is by all means qualified as a journalist and a neurosurgeon to be a surgeon general, but what does it really mean to be surgeon general?  From the website of the Office of the Surgeon General:

The Office of the Surgeon General, under the direction of the Surgeon General, oversees the operations of the 6,000-member Commissioned Corps of the U.S. Public Health Service and provides support for the Surgeon General in the accomplishment of his other duties. The Office is part of the Office of Public Health and Science in the Office of the Secretary, U.S. Department of Health and Human Services.

The Surgeon General serves as America's chief health educator by providing Americans the best scientific information available on how to improve their health and reduce the risk of illness and injury.

So, yes, qualified he is, Dr Sanjay Gupta.  He does a lot of just that -- he's a journalist who does a lot of work on health information. But it's still a curious thing -- why Dr Gupta was chosen over other possible choices.  Is it because he's one of the most recognizable doctors in America?  I'd like to think Obama's not just trying to put together a celebrity cast.  Is it because he's a health journalist and so has an innate ability of communicating important health news to the public?  Is he really more qualified than other candidates for this post?  Or is he even really qualified for what this job entails?

Back in March 2007, more than 1,000 physicians and medical students, including myself, saw Dr Sanjay Gupta speak as keynote speaker at our joint National Physicians Alliance and American Medical Student Association conferences.  He gave quite a "shiny" presentation, with super fancy powerpoints and moving screens and lots of glitter, and his stories of health reporting and the war in Iraq were quite moving. At his young age of 37, he wowed us with our accomplishments (though I was hoping we wouldn't leave such inspiring conferences with a superhero mentality -- that only a few people can do the good work.  I'm obviously a big fan of the concept that we're all heroes or have the potential to be -- just maybe not the shiniest, which I'm ok with).

However, a short time later, I saw Dr Gupta on television, and this is where my hesitation comes up about Dr Gupta as surgeon general.  Gupta has very clear biases and conflicts of interest, as a top reporter for CNN.  This is what makes his choice questionable, in my mind.

Right before Michael Moore was slated to be interviewed by CNN's Wolf Blitzer, about "Sicko", CNN ran a segment called "Reality Check" by Dr Gupta, on the myths and biases of the movie.  It was truly disgraceful, in that this "reality check" was not well fact-checked and full of mistruths (some of which Gupta later apologized for).  The following day, Michael Moore was interviewed by Blitzer, and he argued against all the "facts" that Gupta presented (both segments presented below):

That night Michael Moore also put his Truth Squad to work, publishing some refutations of Gupta's arguments.

Later, Dr Gupta discussed Michael Moore's arguments (and sounding so very well like a politician):

Michael Moore and Dr Sanjay Gupta later faced off on Larry King Live.  Part 1 of the discussion:

And Part 2:

Back to the discussion of surgeon general.  Clear conflicts of interest prevailed in Gupta's discussion of the health care system.  As a journalist, I'm sure he would have fact-checked better -- if not nudged by CNN's advertisers interests.  I'd like our top doc in the White House to be conflict-of-interest free, in the name of restoring integrity to our public health system.  

On the optimistic side, I'm sure my hesitation about Dr Gupta could be assuaged.  And there's wonderful potential for many positive developments and forward-thinking actions -- based on Dr Gupta's immense skills and the Obama administration's interests.  So don't call me a curmudgeon (yet). I'm just sharing some history that I think deserves discussion given the circumstances (and thanks to the collective history and power of YouTube videos).

(of note, Gupta is taking a few days to decide, but it is anticipated that he will accept the offer to be the next surgeon general)