Thursday, February 11, 2016

Taking Aim at the Surgeon General Nominee Misses the Point

There has been no shortage of opposition against the nomination of Dr. Vivek Murthy for Surgeon General, a Harvard and Yale educated physician who trained at one of the nation's best hospitals. Often referred to as "America's Top Doc," the Surgeon General leads the U.S. Public Health Service Commissioned Corps. Notably absent from that job description is the power to pass or enforce legislation and regulation.

Taking Aim at the Surgeon General Nominee Misses the Point


There has been no shortage of opposition against the nomination of Dr. Vivek Murthy for Surgeon General, a Harvard and Yale educated physician who trained at one of the nation’s best hospitals.  Often referred to as “America’s Top Doc,” the Surgeon General leads the U.S. Public Health Service Commissioned Corps.  Notably absent from that job description is the power to pass or enforce legislation and regulation. 

And yet, Dr. Murthy has drawn the ire of the National Rifle Association because of his support for gun control.  Support that he expressed in 2012 in a single tweet.  With his confirmation process stalled, the White House is considering its options.  However, it’s important to highlight that this smear campaign against Dr. Murthy is disturbingly off target. 

1)    We should expect doctors to oppose gun violence and promote gun control

Guns are involved in about 85 deaths a day  and about twice as many injuries due to homicides, suicides, and accidents.  Every major medical organization has come out in support of gun control, including the American Medical Association, the American Psychiatric Association, and the American Academy of Pediatrics.  As a doctor, it’s not only appropriate, but expected that Dr. Murthy would support measures that reduce gun related injuries and fatalities since he and his colleagues are the ones who treat the victims.

2)    He wouldn’t be the first Surgeon General to speak out against gun violence

Doctors do not become politicians by virtue of being Surgeon General, and recent appointees have blurred party lines with their support for gun control measures.  C. Everett Koop, perhaps the most well-known person to hold the position, served as Reagan’s Surgeon General.  While he is remembered as a champion for education on tobacco and HIV, he also recognized the need for regulation of gun ownership.  David Satcher served under the Clinton and Bush Administrations, and vocally promoted gun violence as a public health issue.  It seems the NRA would be hard-pressed to find a former Surgeon General they could endorse.

3)    The Surgeon General is not a regulator who can change gun policy

The Surgeon General serves as a public health educator and advisor.  A similar role to the one Dr. Murthy already fulfills as a member of the U.S. Presidential Advisory Council on Prevention, Health Promotion, and Integrative and Public Health.  Even if he used the position to highlight gun violence—a recognized epidemic by our premier public health institutions, it’s not within the Surgeon General’s authority to impose restrictions on gun ownership or sales.

4)    Guns are an actual threat that require regulation by elected officials

Gun control measures are often framed as attempts at gun abolition, and yet, the logic of “guns don’t kill people, people kill people” doesn’t extend to the regulation of cars.  As a result of safety requirements developed over decades, cars may soon be outpaced by guns for being the leading cause of non-medical death.  Nonetheless, Congress has shown through this nomination process that for now, any gun control bill would be dead in the water. 

5)    The National Rifle Association’s influence is overestimated

The NRA is a lobbying behemoth that has managed to derail a nomination of a qualified candidate by scouring his Twitter account.  Politicians scramble to get and maintain the NRA’s endorsement  (and the accompanying funding), even though its 4.5 million members make up a fraction of the 130 million who vote.  And yet, despite its assumed influence, the NRA has been shown to have virtually no impact on election results.  Why then, do we allow a special interest group to dictate the qualifications of the Surgeon General?

The NRA may be up in arms about gun violence being a public health threat, but until now, we have not allowed special interests to define the practice of medicine.  Blocking his nomination sets a dangerous precedent that politicians and practitioners can be sold to the highest bidder.
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Robert I. Field, Ph.D., J.D., M.P.H. Professor, Drexel University Kline School of Law & Dornsife School of Public Health
Jeffrey Brenner, MD Founder of the Camden Coalition of Healthcare Providers, Medical Director of the Urban Health Institute at Cooper University Healthcare
Andy Carter President & CEO, The Hospital & Healthsystem Assoc. of Pa.
Robert B. Doherty Senior Vice President of Governmental Affairs & Public Policy American College of Physicians
David Grande, MD, MPA Assistant Professor of Medicine at the University of Pennsylvania
Tine Hansen-Turton Chief Strategy Officer of Public Health Management Corporation
Drew A. Harris, DPM, MPH Director of Health Policy Program at the Jefferson College of Population Health
Antoinette Kraus Director of the Pennsylvania Health Access Network
Laval Miller-Wilson Executive Director of the Pennsylvania Health Law Project
David B. Nash, MD, MBA Founding Dean of the Jefferson College of Population Health
Mark V. Pauly, Ph.D. Professor of Health Care Management, Business Economics and Public Policy at The Wharton School
Howard J. Peterson, MHA Managing Partner of TRG Healthcare, a national healthcare consulting firm
Paula L. Stillman, MD, MBA Healthcare consultant with special expertise in population health and disease management
Elizabeth A. W. Williams Senior Vice President & Chief Communications Officer for Independence Blue Cross
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