Vivek Murthy, MD, MBA, US Surgeon General
Office of the Surgeon General
Now, Murthy, who was born in the United Kingdom to Indian immigrants and moved with his family to Miami at the age of 3 years, has added a new job to his resume. He traded his white coat for the blue uniform of the surgeon general of the United States, a position that carries the rank of vice admiral in the US Public Health Service (USPHS).
As “America’s doctor,” Murthy’s job is to communicate “the best available scientific information to the public regarding ways to improve personal health and the health of the nation,” according to his official biography (http://1.usa.gov/1OaZ1bN). He also oversees the 6700 uniformed health officers of the USPHS.
Murthy, who is quick to note that he is not the youngest surgeon general in history—he is a few years older than the first 2 surgeons general, appointed by presidents Ulysses S. Grant and Rutherford B. Hayes, respectively—was narrowly confirmed in December, more than a year after President Obama nominated him.
His nomination was strongly opposed by the National Rifle Association because he supported gun-control laws and by Republicans who questioned whether he was qualified for the job and criticized his political ties to Obama (http://politi.co/1DarKBT). Two days before his ceremonial swearing in on April 23, JAMAspoke with Murthy at his office in the Hubert H. Humphrey Building, the Department of Health and Human Services headquarters at the foot of Capitol Hill.
The following is an edited transcript of the interview.
JAMA:You are the first surgeon general of Indian descent. Your father was raised on a farm in South India. How did he end up becoming a primary care physician in the United States?
Dr Murthy:One of the things I love about America is we have so many extraordinary immigrant stories of people who came to this country under difficult circumstances, who were inspired and guided by a larger vision of what they could be. They worked hard to overcome barriers and to translate that vision into something that was real not just for them but for their kids and their grandkids. That’s the story of my family. My father’s father was a farmer in a rural part of South India in a village called Hallegere, which is my middle name (http://bit.ly/1DamVsd). When he was growing up, nobody had ever gone to college in the village.Even though my grandfather didn’t have much in the way of education or money, he wanted something different for his kids, so he pushed my father to go to medical school. It was very difficult, because medical school was taught in English, and my father didn’t know English all that well. He thought a number of times along the way about quitting, about coming back to be a farmer. But he made it through, and then he went to England shortly after marrying my mother. They thought that would be a place where they could find more opportunity, but they always wanted to come to America because they faced discrimination in many of the places they lived. They always held out hope that if they made it to America, this would be a place where they would be judged based on their ideas and their experience and not on the color of their skin.They poured themselves into building a small medical clinic that my father and mother ran together, where my sister and I helped out as kids. That’s where I got my inspiration to go into medicine, seeing the relationships that my parents built with patients over time and recognizing that to really be a partner in healing, you had to do more than write prescriptions and order diagnostic tests.
JAMA:Both you and your sister followed your father into medicine. Did you ever consider any other profession?
Dr Murthy:When I was in high school, I got very interested in history. I was very interested in English literature, and I had a budding interest in economics as well. I thought I would pursue one of those 3 paths. But what brought me back to medicine was 2 things: one was working in a research laboratory and seeing the incredible power and promise of science to transform people’s lives.The other was building my first nonprofit organization with my sister. I was 17, she was 18 at the time. We were fairly young, but we recognized that HIV was a growing problem in India, and we wanted to build a peer education model and see if it would be effective in helping to educate communities there about preventing the spread of HIV. That got me very excited about public health, and it reminded me of the excitement that I had around medicine when I spent time in my father’s clinic. I really saw medicine as a place where I could bring together science, human relationships, and public health.
JAMA:You’re on Twitter, Instagram, and Facebook. You made a public service announcement with Elmo of “Sesame Street” about the importance of getting vaccinated that went viral (http://bit.ly/1cTCRKu). Why do you think it’s important to have a presence in social media?
Dr Murthy:Social media and digital platforms are a key part of what we’re going to be doing. In an age where we have so many messages about health that are out there, where we have a lot of confusion among people about what’s healthy to eat or not eat, about whether certain procedures and medicines are safe or not, it’s important for us to make sure we’re reaching as many people as possible. We recognize that we have to communicate through traditional media, but we also have to communicate through new media as well. We also have to do things the old-fashioned way, which is to go directly to where people are and to speak with them. My goal as surgeon general is to utilize as many platforms as possible, to partner with a diverse set of individuals and institutions to make sure that our messages around health are reaching as many people as possible.
JAMA:Do you view any particular predecessor as a role model?
Dr Murthy:My favorite surgeon general is C. Everett Koop. He was the first surgeon general that I remember. He was willing to tell the public the truth about health issues when it mattered the most. That’s an important principle for me as well. I recognize that I’ve been entrusted with a great responsibility in this role, which is to look out for the health of millions of people across America. It’s a role I’m honored to take on. It’s one I cherish, one that I will do everything I can to succeed at. But part of that is telling people the truth about what we know and what we don’t know about the important health issues. That’s something that C. Everett Koop did well, and that is something that will be a priority for me during my tenure. I regret that I never had a chance to meet him. But we’ve had other surgeon generals who have done extraordinary work. Dr [David] Satcher was a real leader in addressing disparities in health and mental health. Dr Regina Benjamin, who came before me, was a leader in prevention.
JAMA:In 2012 you tweeted that “guns are a health care issue” (http://bit.ly/1yOET8z). At a Senate confirmation hearing in February 2014, you said you do not intend to use the position of surgeon general as a “bully pulpit” for gun control. Do you still plan not to talk about gun violence, which many physicians consider to be a public health issue?
Dr Murthy:The issues that I want to focus on are the issues that are causing us the greatest loss of life, the greatest disability, and the greatest health care costs, and those are obesity and chronic disease; tobacco-related disease; mental health—where we still struggle with not only providing people with adequate care but getting them to come forward; and substance abuse. Statements that I’ve made in the past around gun violence stem from my experience with patients who have been the victims of gun violence over the years.Violence in general is a public health problem. My job as surgeon general is to address the concerns that the country has. Issues come up. For example, few people anticipated that Ebola would be a big problem a year ago. The measles outbreak that we had at the end of December—that was an issue not everybody would have predicted. My goal as surgeon general is to focus on the issues that are costing us the most in terms of lives and dollars, but to also be nimble and flexible so that we can respond to issues as they arise.
JAMA:What do you do to stay healthy?
Dr Murthy:I can tell you what I do, but I don’t want people to think that’s what they should do. I meditate every morning, and I practice yoga periodically. I do it [meditate] because for me it’s an important part of my emotional and mental well-being. I see emotional and mental well-being as one of the key pillars of a healthy lifestyle. Nutrition, physical activity, emotional and mental well-being, living a life that’s drug- and tobacco-free—these are the pillars that I think are the ingredients for a healthy life. I don’t drink dairy products. That doesn’t mean other people shouldn’t.I try to incorporate activity into my life. That means not just working out on a regular basis, but trying to build activity into work. Whenever possible, I like to convert my sitting meetings to walking meetings. I try to take the stairs. I walk around the building. When it comes to nutrition, I primarily eat a plant-based diet. I eat fish as well. I try to eat foods that are low in salt and don’t have added sugar and consist [mostly] of fresh fruits and vegetables.