Tech + Health

02.14.14

Meet Obama’s Controversial Surgeon General Nominee

Vivek Murthy is before the Senate and could be the youngest doctor to ever hold the post. That’s not the only reason he’s an unorthodox selection.

Dr. Vivek Murthy is on the table before the Senate, undergoing all of the invasive procedures that could make him the nation’s youngest surgeon general ever. 

When President Obama announced his new surgeon general nominee in November, Murthy’s credentials seemed first-rate. He was an internist at Brigham and Women’s Hospital in Boston with an impressive pedigree. He attended Harvard as an undergraduate and then Yale Medical School, and completed his residency at Brigham, where he’s now employed as an instructor of medicine at Harvard Medical. Along the way, he added an MBA from Yale. For good measure, he co-founded Visions Worldwide, a worldwide nonprofit aimed at HIV prevention in India. He’s said his goal as surgeon general would be to tackle America’s obesity problem.

The surgeon general has a multipronged assignment: He or she leads the U.S. Public Health Service, chairs the National Prevention Council, and serves as a de facto communicator to the public on major health issues to prevent illness and injury. The term itself contains misleading nomenclature—the individual does not have to be a surgeon.

The role is something of a figurehead, but can be wielded as a bully pulpit, too—and that is something that concerns his critics: Murthy’s greatest professional accomplishment to date is being an excellent physician organizer.

Two years out of residency, Murthy flashed his political colors. He co-chaired the advocacy group Doctors for Obama during the 2008 presidential campaign. Shortly after the inauguration in 2009, this body of 16,000 physicians changed its moniker to Doctors for America, an organization with the stated goal of improving health-care access. 

For this, Murthy is facing opposition from conservative groups. No recent surgeon general nominee has had such a record of activism. In an election year when the shortcomings of Obamacare have become a major flashpoint, Republicans fear Murthy could use the Office of Surgeon General to become a secondary mouthpiece for the virtues of the new health-care law. Both President Obama and Secretary of Health and Human Services Kathleen Sebelius would likely benefit from a fresher voice supporting their efforts on this topic.

Murthy’s partisanship does not end with his support of the Affordable Care Act. He’s also fired off multiple tweets regarding gun control, including the following:

“Tired of politicians playing politics w/ guns b/c they’re scared of NRA. Guns are a health care issue.”

Surprisingly, he backpedaled from these comments during his Senate hearings this week, claiming he would not use the position as a “bully pulpit for gun control.”

When President Obama famously said “You can keep your doctor,” he could not have been referring to Murthy, who hasn’t been anyone’s “doctor” in the traditional primary-care sense.

While Murthy is unquestionably accomplished, there is one major gap in his résumé: He has never served as a traditional doctor. He is a hospitalist—a type of doctor who performs inpatient shift work, taking care of patients in a non-ICU setting on a floor with medical patients.   

The popularity of hospitalists has increased dramatically in the last two decades, but they tread an insulated path. They don’t endure the rigors of managing a medical practice. They don’t have an office where they see their own patients. They don’t pay their own personal malpractice (the hospital covers that) and they may not even know how much it is. They rarely interact with insurance companies to obtain approvals, process claims, or fight denials of payment. They have fixed hours and don’t generally need to stay past their shifts. They are salaried. They don’t take calls at home regarding any patients. They don’t need to return to the hospital in the middle of the night for emergencies. Hospitalists provide the optimal role for someone like Murthy, who is trying to establish a career outside traditional primary care. 

Interestingly, when President Obama touted his health law by famously saying “You can keep your doctor,” he could not have been referring to Murthy, who by being a hospitalist was never anyone’s “doctor” in the traditional primary-care sense.

Nonetheless, he likely will be soon elevated to the post of Nation’s Doctor. Not a bad first job.