Comments on: The Surgeon General: A Partner In Health Reform http://healthaffairs.org/blog/2008/12/30/the-surgeon-general-a-partner-in-health-reform/ The Policy Journal of the Health Sphere Tue, 07 Feb 2012 22:23:43 +0000 hourly 1 By: Stephen Atwood http://healthaffairs.org/blog/2008/12/30/the-surgeon-general-a-partner-in-health-reform/comment-page-1/#comment-24232 Stephen Atwood Sun, 11 Jan 2009 11:28:07 +0000 http://healthaffairs.org/blog/2008/12/30/the-surgeon-general-a-partner-in-health-reform/#comment-24232 I fully support Dr. Hein’s suggestions and regret the notion expressed by Robert Burney (if I understand him correctly) that the Surgeon General, rather than being a key member of the national health team, holds instead a ceremonial post. Clearly, the Surgeon General, by the nature of her or his background, needs to provide a more technical voice to that team. But in today’s world, where the technology for good health is basically known, it is increasingly important that this individual knows how to translate knowledge into practice, which means examining how health care is delivered and how change, both institutional and individual, is managed. What the nation needs is someone in the office of Surgeon General who not only knows the physiology of disease, but who also understands the social and economic precedents that lead to unhealthy life practices. After analyzing these, she or he should be experienced in methods to help the American public understand these precursors and in the techniques to motivate change from those that are unhealthy. My experience over the last 35 years in the UN and in the USA in public health and clinical and academic Pediatrics suggests that this takes a lot more than posters and ‘messages’, a lot more than media commentary or ceremonial speeches. It requires listening to people to analyze and understand the barriers to change, and facilitating the interventions that people may already want to take but, for various reasons, are unable to do so. The systemic (as well as medical) interventions that arise from this analysis form the foundation of the ‘multi-faceted treatment plan’ that Dr. Hein refers to. This process should be seen as the unique responsibility of the Surgeon General – the key figure who straddles the world of medicine and social change. I fully support Dr. Hein’s suggestions and regret the notion expressed by Robert Burney (if I understand him correctly) that the Surgeon General, rather than being a key member of the national health team, holds instead a ceremonial post. Clearly, the Surgeon General, by the nature of her or his background, needs to provide a more technical voice to that team. But in today’s world, where the technology for good health is basically known, it is increasingly important that this individual knows how to translate knowledge into practice, which means examining how health care is delivered and how change, both institutional and individual, is managed.

What the nation needs is someone in the office of Surgeon General who not only knows the physiology of disease, but who also understands the social and economic precedents that lead to unhealthy life practices. After analyzing these, she or he should be experienced in methods to help the American public understand these precursors and in the techniques to motivate change from those that are unhealthy. My experience over the last 35 years in the UN and in the USA in public health and clinical and academic Pediatrics suggests that this takes a lot more than posters and ‘messages’, a lot more than media commentary or ceremonial speeches. It requires listening to people to analyze and understand the barriers to change, and facilitating the interventions that people may already want to take but, for various reasons, are unable to do so. The systemic (as well as medical) interventions that arise from this analysis form the foundation of the ‘multi-faceted treatment plan’ that Dr. Hein refers to. This process should be seen as the unique responsibility of the Surgeon General – the key figure who straddles the world of medicine and social change.

]]> By: joseph.odonnell@dartmouth.edu http://healthaffairs.org/blog/2008/12/30/the-surgeon-general-a-partner-in-health-reform/comment-page-1/#comment-24221 joseph.odonnell@dartmouth.edu Fri, 09 Jan 2009 03:33:38 +0000 http://healthaffairs.org/blog/2008/12/30/the-surgeon-general-a-partner-in-health-reform/#comment-24221 Bravo Dr Hein!! I fully endorse your suggestions. I am now Senior Scholar in the C Everett Koop Institute at Dartmouth. I have always marvelled at the effectiveness and impact that Dr Koop had in this office, using it as a "bulley pulpit " to express courageous opinions that dealt with the health of the public. We look to our surgeon general, not as a ceremonial position, but as the nation's (and indeed as Dr Hein points out), the world's source of advocacy for health and advice about staying healthy. With the current crisis in financing of our system and the types of outcomes that no one wants, we need as many strong and unbiased voices in leadership helping us to do better. We can do better, and the voice of a wise and strong surgeon general will be a very positive force for improvement Bravo Dr Hein!!

I fully endorse your suggestions.

I am now Senior Scholar in the C Everett Koop Institute at Dartmouth. I have always marvelled at the effectiveness and impact that Dr Koop had in this office, using it as a “bulley pulpit ” to express courageous opinions that dealt with the health of the public. We look to our surgeon general, not as a ceremonial position, but as the nation’s (and indeed as Dr Hein points out), the world’s source of advocacy for health and advice about staying healthy.

With the current crisis in financing of our system and the types of outcomes that no one wants, we need as many strong and unbiased voices in leadership helping us to do better. We can do better, and the voice of a wise and strong surgeon general will be a very positive force for improvement

]]> By: Morning Health Reform News: January 7, 2009 - US Health Crisis http://healthaffairs.org/blog/2008/12/30/the-surgeon-general-a-partner-in-health-reform/comment-page-1/#comment-24198 Morning Health Reform News: January 7, 2009 - US Health Crisis Wed, 07 Jan 2009 16:20:05 +0000 http://healthaffairs.org/blog/2008/12/30/the-surgeon-general-a-partner-in-health-reform/#comment-24198 [...] The Surgeon General: A Partner In Health Reform But over the past 50 years, even as these valiant efforts and life-saving programs saved countless lives and raised awareness, our health care system has fallen apart – and more recently, the Surgeon General’s voice has been muted. Now that President-elect Barack Obama has proposed Tom Daschle and Jeanne Lambrew to lead his new health reform team, it’s time for us to redefine the Surgeon General’s role as someone who can not only diagnose what’s wrong with our health care system but work with us, as a team, to fix it. [...] [...] The Surgeon General: A Partner In Health Reform But over the past 50 years, even as these valiant efforts and life-saving programs saved countless lives and raised awareness, our health care system has fallen apart – and more recently, the Surgeon General’s voice has been muted. Now that President-elect Barack Obama has proposed Tom Daschle and Jeanne Lambrew to lead his new health reform team, it’s time for us to redefine the Surgeon General’s role as someone who can not only diagnose what’s wrong with our health care system but work with us, as a team, to fix it. [...]

]]> By: RobertBurney http://healthaffairs.org/blog/2008/12/30/the-surgeon-general-a-partner-in-health-reform/comment-page-1/#comment-24178 RobertBurney Tue, 06 Jan 2009 02:20:20 +0000 http://healthaffairs.org/blog/2008/12/30/the-surgeon-general-a-partner-in-health-reform/#comment-24178 My father was also a Surgeon General--back when there were some meaningful duties assigned to that office, like pointing out the link between smoking and lung cancer. I don't know what he would think of your proposal, but doubt he would be enthusiastic. He didn't own a stethescope and was more concerned with the population's health than delivery systems. I also think he would point out that the two individuals you named had already been assigned to that task by the President. We don't need another redundant duty for a now ceremonial office. My father was also a Surgeon General–back when there were some meaningful duties assigned to that office, like pointing out the link between smoking and lung cancer. I don’t know what he would think of your proposal, but doubt he would be enthusiastic. He didn’t own a stethescope and was more concerned with the population’s health than delivery systems. I also think he would point out that the two individuals you named had already been assigned to that task by the President. We don’t need another redundant duty for a now ceremonial office.

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