Will New Surgeon General Make A Difference?

Darshak Sanghavi

hide captionCommentator Darshak Sanghavi is the chief of pediatric cardiology at the University of Massachusetts Medical School and the author of A Map of the Child: A Pediatrician's Tour of the Body.

Courtesy of Darshak Sanghavi

Nominated to be the nation's next surgeon general, Regina Benjamin possesses rich clinical experience as a rural family physician from Alabama. The president praised her as a "relentless promoter of prevention and wellness," and a New York Times profile of her work in Bayou La Batre called her an "angel in a white coat." She even won a prestigious "genius" grant from the MacArthur Foundation last year. There's no question she's an accomplished doctor familiar with the struggles of the poor and disadvantaged.

If confirmed, however, she will enter an office of questionable relevance. The surgeon general holds no authority over any serious research funding, lacks a clear legislative role in health policy, has no regulatory powers, and doesn't even report directly to either the president or the secretary of Health and Human Services.

According to the surgeon general's Web site, the official's primary job is to be "a highly recognized symbol" of the nation's health agencies; essentially, she is the public relations person for other people making the important decisions. Even in that limited role, she may be hamstrung since the surgeon general's entire operations budget, by comparison, is less than one-thousandth of the annual sales budget of Pfizer.

Often billed as the nation's top doctor, the surgeon general now competes for public attention with numerous consumer-oriented health web sites, network and cable news programs featuring physician reporters, and an onslaught of popular books and magazines related to health and wellness. It comes as little surprise, then, that the last occupant of the office most Americans can name is C. Everett Koop, who resigned 20 years ago. How can even an outstanding person like Regina Benjamin re-establish the surgeon general's relevance during such times?

That may be a difficult task, but it's not impossible. She has a few key advantages. First, she's not beholden to any corporate interests, so she's free to look out only for the public good. Second, despite the proliferation of media sources, the actual time and money they devote to quality health reporting is minimal. Third, she's joining an administration which has mastered the use of social networking and innovative media to spread political messages, and that apparatus might be re-tooled to promote health.

Perhaps the most innovative template for Benjamin would be to create something like the Huffington Post, which would be branded as the surgeon general's site and focused on aggregating high-quality health and wellness information, complete with commentary from respected scientists from various federal agencies like the Centers for Disease Control, National Institutes of Health, Food and Drug Administration, and others. She could also produce a weekly surgeon general's podcast or webisode, where she'd explain complex issues, like H1N1 influenza control or cancer screenings, in an entertaining but highly informed manner that blows away the superficial content of other outlets. And of course, she could distribute the messages widely with smart use of social media like Facebook or Twitter.

To be sure, such a role is quite different from being a doctor from a poor Alabama bayou. But Benjamin has a long history of tenacity and innovation that just might make people care again about what the surgeon general has to say.

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