January 7th, 2009 by Dr. Val Jones in Audio, Expert Interviews, Health Policy, News
Tags: Admiral, Public Health, Richard Carmona, Sanjay Gupta, Surgeon General
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Dr. Richard Carmona
Intense debate has broken out across the blogosphere regarding the candidacy of CNN medical correspondent, Sanjay Gupta, for the Office of Surgeon General of the United States. Some argue that he is not qualified for the position, others say that his charisma would be a boon to public health communications. But before we draw conclusions about who’s right for the job, we need to understand what the job entails.
I asked Dr. Richard Carmona, 17th Surgeon General of the United States, to explain the roles and responsibilities of the office. You may listen to our conversation by clicking on the podcast below, or read the summary of our conversation that follows.
[Audio: http://blog.getbetterhealth.com/wp-content/uploads/2009/01/surgeongeneraljob.mp3]
Dr. Val: What is the primary role of the Surgeon General?
Dr. Carmona: It’s the Surgeon General’s responsibility to protect, promote, and advance the health safety and security of the United States. The office of the Surgeon General dates back to 1798, when President Adams passed a law to create the Marine Hospital Service. The lead physician of the service became known as the Surgeon General. The Marine Hospital Service eventually became the US Public Health Service, and the roles and responsibilities of the Surgeon General broadened to include immigration, disaster preparedness (in the case of nuclear and biological warfare), national safety, health prevention, and many complex public health issues that face our nation and the world.
Dr. Val: What sort of experience is appropriate for a candidate of the office of Surgeon General?
Dr. Carmona: A successful candidate for the office of Surgeon General should have deep and broad public health experience, especially as a public health or uniformed military officer. The Surgeon General is given the rank of Admiral, and as such he or she will interface with other Admirals and Generals, and Army and Navy Surgeon Generals, most of whom are career officers with decades of experience in military matters. The Surgeon General must have the wisdom and experience to take on the position of an Admiral and represent our country internationally.
Dr. Val: What does the Surgeon General do on a daily basis?
Dr. Carmona: The Surgeon General is the commander of the US Public Health Service Commissioned Corps, which consists of thousands of officers in hundreds of locations around the world working anonymously to keep our nation and our world safe. The Surgeon General interfaces on a daily basis with the NIH, CDC, SAMHSA, HRSA, and all of the federally related health agencies as well as global health organizations like the World Health Organization, Pan American Health Association, and the American Public Health Association. The Surgeon General provides in-depth analysis of health policy for every cabinet minister, including the Interior, Commerce, and Homeland Security. It’s a very visible, credible, and iconic position.
Dr. Val: What’s the selection process for the office of Surgeon General?
Dr. Carmona: The Surgeon General is nominated by the President of the United States after much due diligence, and under the recommendation of his staff. The candidate is then introduced to the United States Senate. Then the Senate, if they so choose, extends the candidate the privilege of appearing before them for a Senate confirmation hearing. During the hearing they review the candidate’s credentials and ask him or her questions about anything and everything related to the public health of this nation and the world. You’re essentially put in a hot seat, and rightfully so because the Surgeon General is America’s face of public health to the world.
Dr. Val: What should Americans expect of their Surgeon General?
Dr. Carmona: The Surgeon General of the United States needs to remain a non-partisan physician. He or she should always communicate the honest, scientific truth to the American public so that they can make informed decisions about improving their health. Often, that scientific information is not the same as the policy that the President or Congress come out with, because policy is a very complicated process.
The Surgeon General has the largest medical practice in the nation (300 million), and when he or she issues reports, they actually change behavior in our country and the world. The Surgeon General is the true, honest broker of the best science for the people, offered in an a-political fashion. He or she is a patient advocate at the very highest level of government, and is expected to address the most complex health problems that face our nation. There is no more important or influential office that an American physician can hold.
December 18th, 2008 by Dr. Val Jones in Audio, Expert Interviews
Tags: Dr. Val Jones, Emme Deland, Healthcare Globalization, Medical School, Medical Tourism, New York Presbyterian Hospital
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I often cringe when I see charts displaying parallel growth lines of these two variables: the number of American fast food restaurants in a given country and local obesity rates. The bad news is that our unhealthy eating habits have been exported successfully to foreign countries. The good news is that we’re going to export hospitals and health services next.
I spoke with Emme Deland, Senior Vice President of Strategy at New York Presbyterian Hospital, about the globalization of healthcare and the exportation of American health technology and expertise. You may read my summary of our discussion, or listen to the podcast here:
[Audio:http://blog.getbetterhealth.com/wp-content/uploads/2008/12/deland.mp3]
Dr. Val: Where does New York Presbyterian Hospital stand in terms of the global marketplace for medical tourism?
Deland: We’ve spent the last couple of years reviewing our strategy regarding medical tourism because we want to be a part of the global healthcare economy. There is a growing market for hospital development overseas, particularly in India, the Middle East, Eastern Europe, and China. The US offers the most advanced medical care in the world, and it’s only natural that other countries want to begin importing it. Whether it’s minimally invasive surgery, infertility techniques, or prenatal diagnostics and care – America is among the global leaders in health technology and services.
Dr. Val: What do these countries want to import exactly? Providers, infrastructure, physical plants, data systems, consultants who can advise on ways of doing things to reduce errors and improve quality?
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December 16th, 2008 by Dr. Val Jones in Audio, Expert Interviews
Tags: AMA, American Medical Association, Consumer Health World, Dr. Joseph Heyman, Dr. Val Jones, Medical Tourism
3 Comments »
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Dr. Joseph Heyman
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Alright I admit it, that was a rather provocative title. The truth is that at the end of a recent interview with Dr. Joseph Heyman, the chair of the board of trustees of the AMA, I was in fact chided for having left full time clinical practice. Dr. Heyman was rather avuncular in his tone when he stated,
You are robbing patients of the opportunity to have a good clinician like you involved in their care. I guess it reflects badly on our profession that the best and brightest are making alternative career choices – practicing clinical medicine is becoming unbearable.
No amount of protest on my part (about my volunteer work at Walter Reed) would convince Dr. Heyman that I hadn’t abandoned my profession to some degree. And it touched a chord with me too – because taking care of patients is very gratifying for me in many ways. It was with a heavy heart that I chose to become a medical journalist instead.
And so back to the interview with Dr. Heyman. We had an interesting discussion about the concept of medical tourism:
You may listen to our conversation here, or read my summary below.
[Audio:http://blog.getbetterhealth.com/wp-content/uploads/2008/12/heyman.mp3]
Dr. Val: Is medical tourism about people coming to the U.S. for care, or about patients leaving the U.S. to get more affordable care elsewhere?
Dr. Heyman: Historically, medical tourism has been about patients coming to the United States to get high quality care. Nowadays, people are realizing that there are wonderful places overseas where they can seek treatment. If they don’t have a very exotic illness, or require a highly specialized procedure, they can get appropriate care overseas. Hip replacements are a good example of a standard procedure that can be performed without too much difficulty. It wouldn’t be as much of a draw for patients who need hip replacements to come to the U.S. Read more »
December 15th, 2008 by Dr. Val Jones in Expert Interviews
Tags: Consumer Health World, Health 3.0, Skip Brickley
1 Comment »
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Skip Brickley
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Skip Brickley is the master mind behind the popular Consumer Health World conference series. He is a natural communicator, and a bundle of positive energy. I was pleased to have the chance to interview him last week about his provocative views on healthcare reform. Enjoy the conversation:
Dr. Val: Tell me about the importance of “community” in healthcare reform.
Brickley: I’ve been thinking about the healthcare problem in this country for many years. First of all, I believe that the wellness of a community is related to the economic health of that community. Therefore, improving healthcare is about improving the economic health of this country at the community level. Successful communities like Silicon Valley, Raleigh-Durham, and Cambridge, Massachusetts have similar underlying reasons for their success: they figured out what they’re good at, learned out how to monetize it, and then found the necessary support for a global reach. They involved all the key stakeholders (at the community level) in their singular purpose: educational institutions, government, consumers, businesses, and non-profit partners.
Although I don’t agree with Hillary Clinton on her approach to healthcare reform, I think she’s right about starting at the community level. Our education system must teach people to value their health as their #1 asset, to provide them with the tools and training necessary to manage their personal finance, and to create ongoing programs to keep the community focus in the forefront. People need to feel that their health choices don’t just affect them, but it impact their entire community.
For example, when we realized that second-hand smoke could be deadly to others, we were able to enact legislation to ban smoking from common areas, and dramatically reduce the population’s overall exposure to cigarette smoke. We need to make that leap in healthcare too – for example, eating two Big Macs at a time is like second-hand smoking for those around you. Because that kind of lifestyle choice is going to cost your community a lot in the future when they have to pay for the inevitable health consequences of such behavior.
When the individual consumer has no contract in the health relationship, any health initiative is doomed to fail. Community leaders must rise up to help us change the culture of health in America. We must align healthcare with community economics – providing incentives for behavior change, and effective education to make people aware that bad choices affect us all. Cowtowing to the whims of consumers is what caused our current financial crisis – we need leaders who will do what’s best for communities, rather than follow faddish trends.
Dr. Val: What is “Health 3.0?”
Brickley: Health 3.0 is where the consumer and the provider engage online together. If providers don’t connect with consumers online, there will be no trust developed and the two groups will continue to exist in parallel universes.
Dr. Val: What inspired you to create the Consumer Health World conference?
Brickley: I wanted the conference to be a catalyst for change. I’m a conversation facilitator – and the event brings together key healthcare stakeholders so they can plan a multi-faceted, community-based approach to healthcare reform. If we can inspire communities to organize themselves around personal responsibility, teamwork between providers and patients online, and legislated incentives for behavior modification – all the while using the “Silicon Valley model” to encourage entrepreneurial, local economic development – we can reform healthcare and improve the health of this country, one community at a time. Consumer Health World stimulates discussion amongst the people who have the power to make these changes a reality. I can’t wait to witness the fruit of these discussions.
December 9th, 2008 by Dr. Val Jones in Audio, Expert Interviews
Tags: 2008 National Health Leadership Patient Safety Leadership Award, Dr. Michael Shabot, Dr. Val Jones, Healthcare Quality, Memorial Hermann, National Press Club, Quality
3 Comments »
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Dr. Michael Shabot
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I recently interviewed Dr. Michael Shabot, Memorial Hermann Hospital System’s Chief Medical Officer, about how his hospital is taking steps to improve patient safety and healthcare quality. His hospital was awarded the 2008 National Health System Patient Safety Leadership Award at a ceremony at the National Press Club.
You may listen to your 20-minute interview here, or read my summary of it below.
[Audio:http://blog.getbetterhealth.com/wp-content/uploads/2008/12/shabot.mp3]
Dr. Val: Tell me about what Memorial Hermann has been doing in the area of hospital quality and safety.
Dr. Shabot: We operate Memorial Hermann Healthcare System on the premise that all patients, visitors, and staff will have an absolutely safe environment. In fact, six of our hospitals have gone a year without a single case of hospital-acquired blood stream infections, or ventilator-associated pneumonia.
Larry Kellner, the CEO of Continental Airlines, can travel on any one of his airplanes without checking on the credentials of the pilots. But would you advise a family member to go to a hospital without checking its credentials or being under the care of a physician whom you know and trust? I wouldn’t.
Every single one of our hospital employees has gone through our “cultural transformation” training. They are taught new ways of doing their current jobs – based on safety training with a proven track record in the aircraft and nuclear energy industries. We also feature employees who have “good catches.” Last month’s “good catch” employee found a medication that was packaged incorrectly from the vendor. It was in the correct bin of our computerized dispensing system, the outer package was correct, but the bottle inside contained a different dose. And this medicine was going to be given to a tiny baby in our neonatal ICU. That incorrect dose could have caused terrible harm, but thanks to the alert nurse – we caught the error.
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