Published January 31, 2018|4 min read
Jerome M. Adams became the 20th surgeon general of the United States on Sept. 5. Adams is not a surgeon. He's an anesthesiologist. And though he wears a uniform, it's not because he's a general — he's a vice admiral of the Public Health Service Commissioned Corps.
It's not surprising there's a lot of confusion about what the surgeon general does. The office of the surgeon general is probably familiar to most people as the author of the label on cigarette packaging that warns of the dangers of smoking. But there's more to the job than that.
The surgeon general is often called "The Nation's Doctor." You can't book an appointment or anything, but he is tasked with diagnosing the nation's health problems and suggesting ways to fix them. The surgeon general is also in charge of the Public Health Service Commissioned Corps, a uniformed service of the United States that responds to health emergencies and promotes public health.
Let's take a closer look at what the surgeon general does and how it might affect you.
The most visible role the surgeon general plays is to talk to country about health, whether in public speeches or scientific reports. The current surgeon general spends a lot of time talking about the opioid crisis. Adams has made addiction his top priority and wants to make naloxone, a drug that reverses the effects of opioid overdoses, more widely available.
Since 1878, the office of the surgeon general has published Public Health Reports, a peer-reviewed journal on public health issues. The most famous report came out in 1964, when then-surgeon general Luther Terry published "Smoking and Health." The 150,000-word study said cigarette smoking was the main cause of lung cancer in men, in the face of a hostile tobacco industry and a country where nearly half of all adults smoked.
The report led Congress to pass a law mandating cigarette packaging include the warning label we all know and love, and helped lead to the widespread acceptance of smoking's risks.
The most famous surgeon general is probably C. Everett Koop, who had to battle political considerations and social mores to address the AIDS crisis in the 1980s. President Ronald Reagan, who appointed Koop, and his administration were initially reluctant to speak out on the disease, because they believed victims of the disease brought it on themselves, according to a profile of Koop by the U.S. National Library of Medicine.
After thousands of deaths, Reagan finally allowed Koop to create a report on AIDS. Koop took pains to publish a science-based assessment of the disease and how to prevent it, including the use of condoms and widespread sex education. Koop sent a condensed version of the report to all 107 million households in the country, not only the largest mailing ever in America, but also "the first time the federal government provided explicit sexual information to the public."
The education campaign helped change attitudes and outcomes on AIDS, which is now able to be treated largely as a chronic, rather than a fatal, disease.
The surgeon general also helps run the Public Health Service Commissioned Corps, comprising more than 6,700 doctors, nurses, dentists and other public health professionals. Uniformed service members respond to public health emergencies both at home and abroad, including disasters like Hurricane Sandy and outbreaks like the Ebola virus in Liberia.
Clearly, past surgeons general have had a huge impact on American public health. Luther Terry's revelations about tobacco and C. Everett Koop's openness on AIDS helped save lives. But these days, the voice and power of the position has been eroded, according to Mike Stobbe, author of "Surgeon General's Warning: How Politics Crippled the Nation's Doctor."
In the book, Stobbe argues that while the surgeon general may have once been the most powerful voice for health in the country, that power has been slowly stripped away to the point of irrelevance. While Koop and Terry had the personalities to overcome political opposition, in more recent years, later administrations have been more willing to fire troublesome surgeons general.
"In the past decade, in both Republican and Democratic administrations, surgeons general have become essentially invisible," Stobbe writes.
So where can you turn for solid health information? The surgeon general still puts out health reports, though they may not be as earth-shattering as in past years. And you can always turn to your doctor. Just be careful with medical advice you read online.
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