Surgeon General of the United States
The Surgeon General of the United States is a high-ranking government official responsible for promoting public health and establishing a national health agenda. Operating under the U.S. Public Health Service, the Surgeon General communicates vital health information to the public through advisories, reports, and calls to action aimed at improving health and preventing illness. The office has evolved since its inception in the late 18th century, starting with a health care initiative for seamen in 1798, and has grown significantly in scope and responsibility over the years. By the 2020s, the Surgeon General oversees a team of over six thousand medical officers and plays a crucial role in shaping health policies, often addressing pressing issues such as smoking, drug use, and disease prevention. Appointed by the President for four-year terms, the Surgeon General is sometimes referred to as the "Nation's Doctor," symbolizing a commitment to public health education. The role has adapted to meet the challenges of modern health crises, such as the COVID-19 pandemic, serving as a key spokesperson for government health initiatives. Overall, the Surgeon General's office reflects the changing landscape of health care in the United States and its increasing focus on the health of all citizens.
Surgeon General of the United States
The Surgeon General of the United States is a government officer tasked with setting and promoting a national agenda for health topics. The surgeon general, assisted by the US Public Health Service, uses advisories, calls to action, reports, and other means of communication to educate Americans about how to improve their health and avoid injury and illness. The Office of the Surgeon General developed over nearly the entire lifespan of the United States, beginning with a healthcare plan for seamen in the 1790s. In the 2020s, the surgeon general oversees more than six thousand medical officers and has an important role in health policies. Presidents of the United States nominate surgeon generals to serve four-year terms.
Background
In the earliest days of the United States, the country had no real centralized health authority. The government had little say in medical affairs. Most people relied on community doctors with varying types and amounts of education, or on homemade holistic remedies unproven by formal science. However, as the nation grew and developed, ideas about healthcare evolved, and government offices began taking increasing responsibility for the health of citizens.
The roots of the Office of Surgeon General can be traced back to the first decades of the US government. The first step took place in 1798, during the administration of President John Adams. That year, officials passed legislation that created a healthcare fund for merchant seamen. The next year, military seamen were added to the program. Funding for medical services would be drawn from money eligible seamen earned for their work. This funding went toward building medical facilities near port cities, where they would be most useful for people who worked at sea.
Although this early healthcare plan worked well for several decades, by the end of the Civil War in 1865, it had been virtually abandoned. Government officials sought to create a new but similar approach to sailors’ healthcare with the Marine Hospital Service system of 1870. Leading this new system would be a new government official, known at the time as the supervising surgeon. The supervising surgeon was a medical expert charged with overseeing the hospitals and making important decisions about how they served their clients and used their funding. This new official also had the task of hiring doctors, nurses, and other medical staff.
The first supervising surgeon was Dr. John Woodworth, who served from 1871 to 1879. In 1873, the name of the office changed to supervising surgeon general—in this title, “general” means “chief” or “leader.” In 1902, the title was shortened to surgeon general. These name changes occurred as the nature of the office, and the organization it oversaw, continued to evolve.
Overview
On January 4, 1889, government officials created the Commissioned Corps, an organization of medical personnel that would include the members of the Marine Hospital Service. The Commissioned Corps was styled in a military-type hierarchy and its members were given authority equivalent to members of the armed forces. For example, the surgeon general was assigned the level of responsibility and power of a US Navy admiral.
By the late nineteenth century, with the expansion of the United States and the growing power of its federal government, the scope of Marine Hospital Service and Commissioned Corps responsibilities was increasing far beyond the original design. One of the most important and extensive new duties was monitoring the growing tide of immigrants coming into the United States. Marine Hospital Service personnel had the task of examining newcomers to the country in major arrival ports such as Ellis Island to ensure that the arriving immigrants were healthy enough to become functioning citizens. The surgeon general became the figurehead of that effort.
The shift to immigrant health greatly expanded the size of the Service and the influence of the surgeon general. Instead of just caring for American sailors, Service members now had broad responsibilities for the health of large sections of the growing country. To reflect this new task, the Service published the first Public Health Reports in 1878. These reports provided statistics and recommendations approved by the surgeon general for the health of sailors, immigrants, and Americans overall.
This evolution of the Service led to a new name, the US Public Health Service, in 1912, along with a variety of new responsibilities. These included monitoring vaccines being developed to combat various illnesses as well as the sanitation of American urban centers. By 1918, the Office of the Surgeon General and the Public Health Service grew again, gaining emergency powers. They had to help America cope with the devastating Spanish flu outbreak (1918-1920), as well as waves of sick and wounded soldiers returning from the battlefields of World War I (1914–1918).
By the 1960s, the Office of the Surgeon General and the Public Health Service had grown into a major part of the government. They saw extensive restructuring in the coming decades, though, with the Surgeon General’s Office being shuffled within the federal government hierarchy. Officials disagreed on the ideal relationship between the surgeon general and other important public health officials. Ultimately, the Office of the Surgeon General became part of the US Department of Health and Human Services’ Office of the Assistant Secretary for Health. Its role in government assured, the Surgeon General’s Office and Public Health Service began to grow and modernize to meet changing public needs.
The surgeon general oversees thousands of uniformed members of the Public Health Service. Together, these medical professionals work to improve and protect the health of all American citizens. The surgeon general—sometimes known as the “Nation’s Doctor”—works to educate people by providing research and recommendations about good health through various advisories, calls to action, reports, and addresses. They take on topics ranging from smoking and drug use to disabilities and exercise. In addition, during health crises such as the COVID-19 pandemic that began in 2020, the surgeon general serves as a figurehead of government health policies.
In 2021, President Joseph Biden appointed Rear Admiral Susan Orsega acting surgeon general, where she served for about three months. President Biden nominated Dr. Vivek H. Murthy to be the twenty-first surgeon general. Murthy also served as the nineteenth surgeon general from 2014 to 2017.
Bibliography
“About the Office of the Surgeon General.” Office of the Surgeon General, 18 Mar. 2024, www.hhs.gov/surgeongeneral/about/index.html. Accessed 19 Dec. 2024.
“Brief History.” US National Library of Medicine, profiles.nlm.nih.gov/spotlight/nn/feature/system. Accessed 19 Dec. 2024.
“History of the Office of the Surgeon General.” Office of the Surgeon General, 13 Feb. 2015, www.hhs.gov/surgeongeneral/about/history/index.html. Accessed 19 Dec. 2024.
“Office of the Surgeon General (OSG).” Office of the Surgeon General, www.hhs.gov/surgeongeneral/index.html. Accessed 19 Dec. 2024.
Office of the Surgeon General. The Surgeon General’s Vision for a Healthy and Fit Nation. U.S. Department of Health and Human Services, 2012.
“Previous Surgeons General.” Office of the Surgeon General, 11 Mar. 2022, www.hhs.gov/surgeongeneral/about/previous-surgeon-generals/index.html. Accessed 19 Dec. 2024.
Salerno, Judith, and Paul Theerman. “Looking Out for the Health of the Nation: The History of the U.S. Surgeon General.” The New York Academy of Medicine, 23 Oct. 2018, nyamcenterforhistory.org/2018/10/23/surgeon-general. Accessed 19 Dec. 2024.