There was a moment of awe as 400-plus American physicians spontaneously rose to their feet earlier this month to welcome Dr. Regina Benjamin, the 18th U.S. Surgeon General.
Their response was instinctive, far warmer than the expected one-hand salute of applause and rustling file folders at the tail end of a long conference day. It was a coup for the surgeon general to address the conference, but that seemed precisely fitting. If the surgeon general’s message of prevention is going to mobilize an army, the health-care professionals attending this conference would constitute the front lines of a national battle to treat chronic diseases created by unhealthy eating and poor exercise habits, she said.
As the overseer of the U.S Public Health Service Commissioned Corps, Benjamin is “America’s doctor” and oversees 6,500 uniformed public health officers who serve around the world. The surgeon general, natty in her navy uniform bedecked with rows of ribbons and gold braids, easily commanded respect, though she seemed a little overwhelmed by it all. “I’m just a family physician who felt that one person could make a difference,” she said quietly.
Her message, her public health priority, isn’t to get the country to stop smoking or to wear seat belts. Her primary objective as surgeon general is prevention, and if it takes turning the American medical establishment on its head to do it, she just might. The physicians and other health care providers who attended the 2011 Healthy Kitchens, Healthy Lives Conference, jointly presented by Harvard Medical School and Culinary Institute of America (CIA) and organized by Harvard’s Dr. David Eisenberg, are a self-selected segment of American medicine that understands the challenges the surgeon general faces in translating her message of prevention into the highest health care priority for the nation.
When Benjamin became the surgeon general, it wasn’t complicated for her to winnow down the list of possible top priorities to one: Prevention.
“I’d been a family practitioner in Alabama, and as a family practitioner, you see everything, and you do everything. Our national challenge isn’t about curing disease, it’s preventing it. We have wonderful tertiary care, remarkable hospitals. But what we must do is prevent people from getting to the hospitals. To get from here to there will take the involvement of the whole community. But how do doctors get paid for prevention? The hardest groups to get involved in prevention are medical clinicians –– because we haven’t yet worked out how to compensate doctors for keeping people out of the hospital. That’s one of the biggest arguments for national health insurance.”
‘One physician can make a difference’
As a young medical intern, she wondered at a major medical conference why sexually transmitted diseases weren’t covered in her medical textbooks. She became the catalyst for including STDs in standard training. She says it taught her “that one person can make a difference. A very good thing to learn early in your career.”
Benjamin went on to found the Bayou La Batre Rural Health Clinic in Alabama, (more than occasionally financing operations out of her own salary). She became the first physician younger than 40 to be elected chairwoman of the Federation of State Medical Boards in 1995, and the first African-American woman to be elected to the American Medical Assn. Board of Trustees. Benjamin received the Nelson Mandela Award for Health and Human Rights in 1998 and a MacArthur Genius Award Fellowship, among other accolades. A bit more than standard for a rural country doctor.
As surgeon general, she has created the first multidisciplinary National Prevention Council.
“We have a tremendous opportunity to look at how to prevent people from getting sick in the first place.” She admits that the $15 million budget is smaller than she’d hoped, but acknowledges that in Washington as elsewhere, “all budgets are in the slice-and-dice mode.”
At the conference, the specific health-prevention focus is obesity, a blooming social and medical issue with grave implications for the future of the American health-care system. Most of the physicians in attendance were there to learn new strategies for weight management for their patients and themselves.
Walking the walk
“The sobering impact of obesity on chronic diseases is now a national crisis,” Benjamin said. “We see children as young as age 3 exhibiting signs of Type II diabetes.” The surgeon general says she was pleased to stand with first lady Michelle Obama in the Rose Garden to announce the launch of her Let’s Move campaign. “I share with the first lady the belief that we can solve the problem of obesity in one generation.”
Benjamin believes that we have to engage in a national conversation about obesity, at all societal levels. We have to get America to take responsibility for their health and their fitness. Nor does she think that the emphasis on fitness should be about dress size.
“Exercise is medicine! Exercise is its own reward! Regardless of your size, you still have an obligation to be as fit as you can be,” she said, a woman herself who could be charitably described as chunky. “But to get there, we have to make the ‘easy’ choices be the healthy choices. We have to remake our priorities to support being fit and healthy. We need to figure out a strategy how to make healthy meals compete for the same dollar as fast food meals. ”
Benjamin recalls a patient who came in to her office, complaining that she had no money to go to a gym or time to work out. Benjamin gave her two soup cans to use for bicep curls.
The doctor herself is “walking the walk.” She’s organized the Surgeon General’s Walk Around the Nation. In Boston, she led a conference full of physicians on a White Coat, White Sneakers Walk through Boston Common. One of the doctors in Napa who had been on the walk in Boston characterized it as more like a “forced march.” Dr. Edward Phillips recalls: “The surgeon general puts on quite a pace.” She is training for a half marathon in New York and claims that she doesn’t care how long it takes as long as she finishes before the street sweepers. “If I can do it, anyone can.”
Her last word to the doctors: “As your physician, I ask you to take care of yourselves. Coming to the conference is one of the good things you have done. Just like they tell you on the airplane, put your own face mask on before putting one on your patients. Take care of yourself.”
Zester Daily contributor Louisa Kasdon is a Boston-based food writer, former restaurant owner and founder of letstalkaboutfood.com. She is a columnist for the Boston Phoenix, the food editor for Stuff Magazine and has contributed to Fortune, MORE, Cooking Light, the Boston Globe, Boston Magazine and the Christian Science Monitor, among others.
Photo: Surgeon Gen. Dr. Regina Benjamin chats with Dr. David Eisenberg during the Healthy Kitchens, Healthy Lives Conference, jointly presented by Harvard Medical School and Culinary Institute of America (CIA).
Credit: John Barkley