Daliah Wachs, MD, FAAFP
Chief of Staff, Attorney General, Secretary of State….positions of utmost gravity to this new administration. But should the choice for the head of the Office of Surgeon General be treated lightly? The Surgeon General advises the Secretary of Health and Human Services and is the main spokesperson for the US when it comes to public health. Beyond key administration players in economics, national security, environment and healthcare lies a pivotal individual who has the power to affect all of the above. And we anticipate the upcoming term of the Surgeon General to be a doozey……Here’s why….
- The repeal of Obamacare – The ACA not only affected insurance premiums and Medicaid access but strikingly, the economy. Penalties levied on employers for not insuring employees accelerated full-time unemployment and encouraged the formation of millions of part-time positions, not required to be insured. The economy continued its stagnation and high deductibles thwarted many people from using their health insurance, hence less healthcare dollars being spent. A Surgeon General’s role in the new healthcare system could obviously affect the economy’s growth and strength.
- Zika and other insect-vectored diseases – man cannot control nature and every attempt to risks making the situation worse. Options to aerial spray with pesticides or release GMO mosquitoes are very controversial. West Nile, Zika, Dengue are just a few of the mosquito born illnesses surging in the US and we haven’t even begun to reach the level of preparedness needed.
- Opioid overdose epidemic – prescriptions written and abused are at an all time high, with overdose deaths occurring in record numbers. However chronic pain is also an epidemic and measures addressing the former are outpacing the latter. Which brings us to…..
- Marijuana is becoming legal in many more states – not only will we anticipate recreational use to increase, but individuals suffering from chronic pain will seek cannabis for relief as pain medications become harder to come by. Logistics of managing drivers under the influence, employee accidents, and teen use have not been ironed out. Although opportunities to study marijuana and incorporate it into medical management can now be pursued, we’re still lacking research on its safety in inhaled, edible, and second-hand smoke form.
- Superbugs are getting stronger – many pharmaceutical companies hampered by ACA restrictions hesitated on the R & D of new drugs and these superbugs, resistant to multiple antibiotics, are gaining speed and strength. We need treatments (not just antibiotics) to be immediately developed to ward these off.
And the list goes on so we can agree our new Surgeon General will be busy. So who should take the job?
Dr. Ben Carson was thought of as a perfect choice….a physician, gets along with Donald Trump, well-spoken…..and additionally it was rumored he was offered Health and Human Services Secretary. However this week we heard he declined being apart of the Trump administration due to lack of government experience and never having run a government agency. But are these qualifications necessary to become Surgeon General?
Although its customary for the Surgeon General to be a physician, I believe anyone who has taken care of patients at length, understands the current public health issues, works to get ahead of the curve before something becomes an issue and demonstrates service to their community and country would be a fine choice. I’ve witnessed so many individuals (nurses, pharmacists, therapists, etc) put their patients and fellow citizens first that when President-Elect Donald Trump does take on the difficult job of vetting the right individual, he has more to choose from than he knows. A Surgeon General does not need to be a surgeon, nor a general. But ultimately he/she is the country’s “doctor”. I wouldn’t take this choice lightly, and I wouldn’t keep the Surgeon General hidden as we’ve seen in previous administrations. Let them take the lead on what they do best…..care.