Why Regina Benjamin was an ineffective Surgeon General

Recently, way beneath all the press about Obamacare, there have been articles panning the president’s pick as the next Surgeon General of the United States. Wait a minute. What happened to the last Surgeon General?

Six months ago, family physician Dr. Regina Benjamin stepped down as the first Surgeon General under President Obama. Quick! Name one accomplishment under Dr. Benjamin. I can’t either. What happened?

Dr. Benjamin was a rising star in the medical community. In 1995, she was the first African-American woman to be elected to the American Medical Association Board of Trustees. She gained a lot of notoriety following Hurricane Katrina in 2005 as one of the only physicians treating patients in her community of Bayou La Batre. I remember seeing her speak in person in 2007 at an AAFP conference. She had a soft spoken presentation, but told a compelling story.

Following the 2008 presidential election, there was a lot of buzz in the press about the possibility of Sanjay Gupta being nominated as Surgeon General. When that did not materialize, Dr. Benjamin’s nomination was announced. The family medicine community rejoiced. However, the press, who was clearly pulling for a Sanjay Gupta nomination, lashed out with headlines like “Is Regina Benjamin, Surgeon General Nominee, Overweight?

This Surgeon General tenure was doomed from the start. Don’t get me wrong, I’m a big fan of Dr. Benjamin and her work. She’s a nice person, but I think this was her downfall as well. Memorable Surgeon Generals include people like C. Everett Coop and Joycelyn Elders. Why? Well, I thought they brought some controversy to the office, and to get attention in Washington DC, you need some controversy.

In Dr. Benjamin’s TED talk, she states that “One person can make a difference.” When it comes to government and politics, I disagree with this. The other lesson learned from this doomed Surgeon General tenure is no one person can make an impact in the huge Washington bureaucracy. You need a great team around you and/or a huge amount of supporters within the Washington machine to get anything done there.

This lesson is important for the #FMRevolution activist community to know. Maybe we could have done a better job pushing back on the press when negative stories were sprouting up about Dr. Benjamin. I believe this negative press removed most (if not all) her potential effectiveness as a Surgeon General.

One of these days, there will be another opportunity for a family physician to be Surgeon General of the United States. The primary care and family medicine community has to prepare for this by looking at our leadership development and advocacy pipelines. Not only do we need to groom tomorrow’s leaders, but also we need to build the numbers of advocates in the public and private sectors to help the next family physician make a difference as Surgeon General of the United States.

Mike Sevilla is a family physician who blogs at his self-titled site, Dr. Mike Sevilla.

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  • http://www.capko.com Laurie Morgan

    Those negative stories made me so sad (and disgusted and ashamed of our media). I also wonder if the unfortunate timing alongside the first lady’s anti-obesity campaigns allowed some reporters to feel justified in their commentary and made things even worse for Dr. Benjamin.

  • ninguem

    What constitutes an “effective” Surgeon General?

    • Kristy Sokoloski

      I was just thinking the same thing. Plus, I wonder just how much Americans really fully understand just what the Surgeon General really does. And in reading that Dr. Benjamin was a Family Medicine physician how could she have used that specialty (or the same for any other Family Medicine physician that may get considered for the role) in the office to have impacted the way this country thinks about Primary Care as a whole?

      • Jess

        It’s basically an activist role. If Dr. Benjamin had advocated vehemently for the importance of every American having a relationship with a family practitioner, and argued against the increasing fragmentation of medical care, the way Dr. Koop advocated for policies to stop Americans from smoking, that might have been good. There are a lot of excellent arguments to put forth in favor of every family having one main primary care physician or family doctor to coordinate their care, rather than seeing a whole slew of assorted doctors, specialists, hospitalists, nurses and midlevels.
        But unfortunately, next to smoking (which, thanks in no small part to Dr. Koop’s activism is on the decline), the next biggest public health crisis is probably obesity and lack of exercise. And just as Dr. Koop’s message about the importance of quitting smoking would have been blunted if he had in fact been an avid smoker himself, any message Dr. Benjamin tried to sell about the importance of physical fitness and staying slender would also have been blunted.

        • Kristy Sokoloski

          Jess,
          Thanks for the reply back. But do Americans understand that fact about this position being an activist role? And do they understand that the role as activist is supposed to be one to help the public such as in the examples you gave? If not, then something must be done to change that. Especially to better explain to “everyone” (yep, that’s just what I meant because I am including those that may not want a Primary Care Physician to coordinate their care) what all is involved in that role as to why it should be left to the healthcare provider and not the patient. Because as you may have seen in several other threads including the one about the diagnosis being missed until after seeing so many doctors we the patient have to do the legwork.

        • ninguem

          The Surgeon General report on smoking was 1964, about 17 years before Koop became Surgeon General under Reagan.

          Funny, when Reagan nominated Koop for the position, the left had fits because of his religious conservatism and pro-life stance.

          I’m sure Koop did lots of anti-tobacco work, but this was well underway before he took the position.

          Does anyone know much about any Surgeon General, apart from Koop?

          Koop is, by all means, an interesting character, and his own man, probably rare in Washington. He spoke his own mind on lots of things, including certain medical practices like prolotherapy, which he advocated. By reports, he had received that treatment, and had actually done it on patients himself.

          • buzzkillerjsmith

            The surgeon general is about one-third as important as the postmaster general.

    • Jess

      This, from the NIH, explains what the role of the Surgeon General, both historically and now, is:
      http://profiles.nlm.nih.gov/ps/retrieve/Narrative/NN/p-nid/58

  • GT

    It was the Obama administration – and especially Mrs. Obama — who really ramped up the “let’s demonize those gross yucky fat people” campaign. Obama should have known better than to let his wife go off chiding all of us commoners for being too fat, and then hiring a fat lady to be his administration’s taxpayer-funded public face of health policy.

    Either fat people are horrible and must be nannied and shamed into submission, or it’s okay for people to be fat. But you can’t have one rule for the elites of the Obama administration and one rule for the proles.

  • GT

    By the way, this very blog took great joy in fat-shaming Chris Christie. OMG, Fat people shouldn’t be in public office!

    http://www.kevinmd.com/blog/2013/03/chris-christie-obese-run-president.html