Wednesday, January 14, 2009

Disease Management and the Necessary Qualifications to Be Surgeon General of the United States

After much reflection, the Disease Management Care Blog concurs with the spouse that it is not qualified to be the next Surgeon General of the United States. It’s not like it can’t handle the duties or won’t look dashing in a uniform. It can’t “pack.” If that wasn’t enough, the DMCB takes pause because of an insight that shared by our last Surgeon General, Dr. Richard Carmona about taking this inside-the-beltway job.

In an immensely informative speech, Dr. Carmona warned that President Truman advised persons in Washington DC to “get a dog” if they wanted any friends. During his tour of service, Dr. Carmona found out that it’s better to get two dogs. That’s because you’ll need the second when the first one turns and tries to bite you.

Given the spouse’s derision as well as the high likelihood that even the most bipartisan lovefesting will turn eventually devolve into partisan rancor, the DMCB is happy to endorse Dr. Sanjay Gupta’s ascent to the post. While his familiarity with all things media is certainly a plus, the DMCB principally supports the nomination because it’ll mean there will be far less of Dr. Gupta when CNN is on. In fact, the DMCB wonders if there is room for an Assistant U.S. Surgeon General and nominates Fox News’ Dr. Manny for the same reason.

But seriously, who should be Surgeon General? While the DMCB is a fan of ‘disease management’ and has many doctor friends in the industry, those aren’t the only reasons why it believes any of the senior physician executives in any of the national level disease management organizations are far more qualified than many in or out of government, media or policy circles would give them credit for. Check out those “Duties of the Surgeon General” and you’ll see terms like ‘educating the public,’ ‘advocating for effective disease prevention and health promotion programs,’ ‘articulating scientifically based health policy analysis,’ ‘promoting …health initiatives e.g., tobacco and HIV prevention,’ and ‘elevat[ing] the quality of public health practice.’ Sounds a lot like the latest approach to population health, doesn’t it?

The DMCB understands the job also involves administering the U.S. Public Health Service Commissioned Corps, advising the President and interacting with a host of governmental entities, but the disease management executives represent a pool of persons with considerable acumen in the art and science of improving quality, optimizing cost and navigating large organizations around competing stakeholders.

Call the it naïve, but to the DMCB, it sounds like the Surgeon General is the Chief Medical Officer of the United States government. The government is currently very interested in lessening the burden of chronic illness. What that insight, just who is best qualified to take the job?

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