Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

6 priorities for the new surgeon general: Advice for Vivek Murthy

Dr. Saurabh Jha
Policy
January 19, 2015
Share
Tweet
Share

In defiance of dire predictions, children haven’t been sent to workhouses and women haven’t been chained to utensils after the GOP gained strength in the House and the Senate. And Vivek Murthy, the unabashed Obamaphile, was finally confirmed surgeon general.

To be honest, I always thought the controversy surrounding Murthy’s nomination because of his stance on gun control was rather daft. Stopping doctors from pontificating over guns, such as the docs vs. glocks legislation, is like banning me from trying to convert Pope Francis to Hinduism. The legislation is a parody not just for its own sake, but because what it seeks to prevent is parody as well.

Murthy’s first challenge is to raise the position of the surgeon general from that tokenism of a career U.N. bureaucrat to something vaguely useful. Which means Murthy must resist the call of banality, the banality of ideology and the ideology of making all of mankind’s imperfections public health problems.

I have the utmost respect for public health. However, public health professionals are at risk of devaluing their work by expanding their dominion and inviting futility. For example, some public health scholars opine that income disparity is public health’s responsibility since disparity signals social injustice, and low income is linked to poor health outcomes. Not only is such a stance moral posturing and laden with ideology, it is prescriptively useless. I cannot imagine Goldman Sachs employing an MD-MPH to ensure that the bonuses doled out are syntonic with Rawl’s distributive justice.

Making health the ultimate good rapidly disintegrates into absurd logical conclusions. I am much perturbed by the events in the Middle East, as are many others, to the extent that it affects my mental and spiritual peace (yes, that is health as well — check the WHO definition if you don’t believe me). Is the Middle East situation a public health problem for the U.S.? If so, should I turn to Vivek Murthy, the surgeon general of the U.S., to solve the root cause of this epidemic of anxiety?

Murthy must minimize his pontificating about societal ills that can tangentially be linked to the health of the nation, over which he has no more control than my jumping on the spot. The more he pontificates about these, the more he will affirm the cosmetic nature of the surgeon general.

That is he must make a distinction between problems affecting public health and public health’s responsibilities.

These include but are not limited to income inequality, anthropogenic global warming, the Keystone pipeline, unpleasantness of modern airline travel, gun violence, and the Second Amendment.

Yes, the Second Amendment. Time to let it go old chap. This is a problem of democracy and a problem for democracy, not a problem that will be solved by the medical profession. To believe otherwise is activism. And your position, sir, should be above the parapet of activism.

It is likely Murthy will be egged on by his supporters, including left of center well-meaning millennials. I would urge Murthy to be nonpartisan. The country is deeply divided, and perhaps a doctor can do what no politician and very few journalists have achieved — transcend politics and ideology. And a surgeon general cannot alienate 47 percent of the population.

Murthy should achieve the imminently achievable, however. Here is my wish list of initiatives or awareness programs that the surgeon general can spearhead.

1. Make kids play. Let’s call it Project Locomotion. Get kids to walk, run, scream, play, anything other than staring at video games and watching TV for countless hours. Let’s have a national “No Video Game Day” where all kids are outside doing what children have historically done, and still do in less affluent societies.

Childhood obesity is a public health problem. It is not a problem of poverty. Locomotion is free. It’s a first-grade of kids not being physically active enough.

ADVERTISEMENT

Get your millennial mates, from colleges and universities across the U.S., to push this initiative at local schools. This will be infinitely more useful than their moral grandstanding about income inequality.

2. Keep kids off Ritalin. Say no to Ritalin. Too many kids are on Ritalin. We are medicalizing the broader coastline of normality. Let me tell you a little secret. Half of my first grade class would have been placed on Ritalin today. At the time they were labeled with that dangerous diagnosis: excitable children. Excitable children! Is that a euphemism for excitable children?

Don’t blame big pharma for the epidemic of ADHD. Big pharma is our servant. It gives us pills for what we can’t handle. If we can’t handle boisterous kids, pharma will happily oblige us with pills.

The number of kids on Ritalin in this country is not only a public health concern but a national shame. Kids need attention. They need to play. But most of all they need self-indulgent, self-absorbed adults to understand that kids will be kids.

3. Reduce antibiotic prescriptions. Too many antibiotics are prescribed frivolously. This is because too many doctors are too afraid, and too many patients, usually the half-informed with a college degree, conflate prescription with care.

Create a mass awareness campaign about the risks of antibiotic resistance. Make a macabre movie directed by Wes Craven about a flesh-eating bacteria that is resistant to all antibiotics destroying Upper East Side, New York.

Scare people. Scare doctors. Make them feel guilty for antibiotic misuse.

4. Move Americans. Not by your speeches. I mean literally. Get them to walk more. Remind your fellow citizens what a beautiful country they are fortunate to live in, with the great outdoors, and well-maintained national parks. If it is the mall they must visit, remind them that even in malls they can walk more, from one end of the mall to the other.

5. Counter the charlatans. This is the raj of quacks. Half-baked information is accessible at the click of a finger. From anti-vaccination fear mongers to peddlers of nutritional supplements, fight them on the Fox network. Fight them on CNN. Fight them on MSNBC.

Use the gravitas of your title to discredit them.

To maintain your own gravitas resist the urge to comment on every single study that links some toxin found in miniscule quantities to a miniscule increase in the risk of cancer. Don’t cheapen your office by losing sleep over the dangers of anti-bacterial soap or germs on credit cards. Don’t worry. The Perfect Health Squad at the New York Times or Vox will cover these stories.

6. Exit with dignity. As you know the waste of resources in trying to extend life by 48 hours is preposterous. Create a bottom up campaign urging physicians to apply common sense when treating patients who are obviously in the last throes of their life. Rally the intensivists. Rally the primary care physicians. Tell people what a dismal epitaph it is to die in a CT scanner with the technologist yelling “take a deep breath in and hold it.”

If anyone accuses you of being a death panelist, refer them to me. Good luck in your job. I understand “Vivek” means wisdom. I hope you will bring a spot of wisdom, a touch of good judgment and an abundance of common sense to the position of surgeon general and to public health at large.

Saurabh Jha is a radiologist and can be reached on Twitter @RogueRad.  This article originally appeared in the Health Care Blog. 

Prev

Do drug seekers in the ER make you burst out in song? It did here.

January 19, 2015 Kevin 21
…
Next

End-of-life care in America is broken at every level

January 19, 2015 Kevin 14
…

Tagged as: Primary Care

Post navigation

< Previous Post
Do drug seekers in the ER make you burst out in song? It did here.
Next Post >
End-of-life care in America is broken at every level

ADVERTISEMENT

More by Dr. Saurabh Jha

  • Masks are an effigy of American technocratic incompetence

    Dr. Saurabh Jha
  • False negative: COVID-19 testing’s catch-22

    Dr. Saurabh Jha
  • Why the Lancet’s editorial on Kashmir is unhelpful

    Dr. Saurabh Jha

More in Policy

  • Who gets to be well in America: Immigrant health is on the line

    Joshua Vasquez, MD
  • Online eye exams spark legal battle over health care access

    Joshua Windham, JD and Daryl James
  • The One Big Beautiful Bill and the fragile heart of rural health care

    Holland Haynie, MD
  • Why health care leaders fail at execution—and how to fix it

    Dave Cummings, RN
  • Healing the doctor-patient relationship by attacking administrative inefficiencies

    Allen Fredrickson
  • The hidden health risks in the One Big Beautiful Bill Act

    Trevor Lyford, MPH
  • Most Popular

  • Past Week

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • America’s ER crisis: Why the system is collapsing from within

      Kristen Cline, BSN, RN | Conditions
    • Why timing, not surgery, determines patient survival

      Michael Karch, MD | Conditions
    • How early meetings and after-hours events penalize physician-mothers

      Samira Jeimy, MD, PhD and Menaka Pai, MD | Physician
    • FDA delays could end vital treatment for rare disease patients

      GJ van Londen, MD | Meds
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
  • Recent Posts

    • Addressing menstrual health inequities in adolescents

      Callia Georgoulis | Conditions
    • How to advance workforce development through research mentorship and evidence-based management

      Olumuyiwa Bamgbade, MD | Physician
    • The truth about perfection and identity in health care

      Ryan Nadelson, MD | Physician
    • Civil discourse as a leadership competency: the case for curiosity in medicine

      All Levels Leadership | Physician
    • Healing beyond the surface: Why proper chronic wound care matters

      Alvin May, MD | Conditions
    • Why specialist pain clinics and addiction treatment services require strong primary care

      Olumuyiwa Bamgbade, MD | Conditions

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 3 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • America’s ER crisis: Why the system is collapsing from within

      Kristen Cline, BSN, RN | Conditions
    • Why timing, not surgery, determines patient survival

      Michael Karch, MD | Conditions
    • How early meetings and after-hours events penalize physician-mothers

      Samira Jeimy, MD, PhD and Menaka Pai, MD | Physician
    • FDA delays could end vital treatment for rare disease patients

      GJ van Londen, MD | Meds
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
  • Recent Posts

    • Addressing menstrual health inequities in adolescents

      Callia Georgoulis | Conditions
    • How to advance workforce development through research mentorship and evidence-based management

      Olumuyiwa Bamgbade, MD | Physician
    • The truth about perfection and identity in health care

      Ryan Nadelson, MD | Physician
    • Civil discourse as a leadership competency: the case for curiosity in medicine

      All Levels Leadership | Physician
    • Healing beyond the surface: Why proper chronic wound care matters

      Alvin May, MD | Conditions
    • Why specialist pain clinics and addiction treatment services require strong primary care

      Olumuyiwa Bamgbade, MD | Conditions

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

6 priorities for the new surgeon general: Advice for Vivek Murthy
3 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...