Surgeon general stresses prevention, wellness to AOA House

On an afternoon when the AOA House of Delegates passed several resolutions related to preventive medicine, the surgeon general of the U.S. Public Health Service pledged to delegates that she will help move the nation’s health system from one based on “sick care” to one rooted in wellness and prevention.

“I want to change the way people think about health in this country,” said Vice Adm. Regina M. Benjamin, MD, USPHS, who was appointed “America’s Doctor” last fall. “That calls for the nation to take a more holistic approach to community health, spanning from safe highways and work-site wellness programs to clean air and healthy food.” This is why the new preventive medicine council established by the Affordable Care Act of 2010 includes the heads of most federal departments, including the U.S. Department of Education, the U.S. Department of Transportation and the U.S. Department of Agriculture, added Dr. Benjamin, who chairs this council.

Even though a snowstorm during a campus visit scared her off from attending the Chicago College of Osteopathic Medicine, Dr. Benjamin was among kindred spirits in a room of more than 400 DOs. The Alabama native, who is an allied member of the AOA, spent more than 20 years as a rural family physician in solo practice serving the working poor.

Dr. Benjamin forged her core values in the Gulf Coast shrimping village of Bayou La Batre, Ala., where she founded a health clinic to care for the town’s impoverished residents. Learning that “there were things the prescription pad wouldn’t take care of by itself,” she built relationships with nonprofit organizations, including the American Red Cross, United Way and literacy-promoting entities, and became increasingly active in medical societies, especially the American Medical Association.

“Practicing medicine wasn’t just sewing up shark bites,” she told the House on July 17 in Chicago. “I had to deal with the ‘land sharks’: the regulators, the reviewers, the red-tape dispensers and what I jokingly call the hammerheads—the lawyers.”

Dr. Benjamin first tasted the fruits of political engagement at a meeting of the Medical Association of Georgia, which she attended while still an intern. After speaking up on a resolution that went on to pass, Dr. Benjamin was dispatched by the association to defend the resolution before the AMA’s policymaking body. Within months of the AMA’s passage of the Georgia resolution, which called for clinical information on sexually transmitted diseases to be taught in medical schools, all U.S. medical schools were urged to cover STDs in their core curricula.

“I learned that one person can make a difference,” Dr. Benjamin said.

Fighting for patients

Despite her prominent position, Dr. Benjamin indicated that she hasn’t lost sight of the kind of people she hopes will benefit from her work.

She told the story of one of her patients, a woman in her early 40s who suffered from back pain. Dr. Benjamin called in a prescription for the woman and asked her to return in a few days.

“On Tuesday, I came into the exam room and there she was like she promised,” Dr. Benjamin recalled. “But she was leaning over the exam table in so much pain that she couldn’t sit down.” Dr. Benjamin learned that that the patient, a school custodian who had good health insurance, never picked up her prescription because she couldn’t afford the co-pay.

The patient then said she intended to return to work that evening because the school’s floors needed stripping. “She was willing to strip the floors of wax so that our kids can go to school and she couldn’t even sit down, she was in so much pain,” Dr. Benjamin said.

“These are the people that I don’t mind fighting for,” she continued. “These are the people we’re trying to make health reform changes for.”

Dr. Benjamin noted that beginning in September, the health reform law will eliminate co-pays for many preventive services, such as mammograms, Pap smears and screenings for diabetes mellitus and hypertension. The Affordable Care Act also provides for financial incentives to help physicians adopt electronic health records. As someone who grappled firsthand with the patient-chart chaos after Hurricane Katrina, Dr. Benjamin stressed the importance of electronic health records to patient safety and public health.

“This is an exciting time to work in our health care system because we have the opportunity to make it better and easier for our patients,” Dr. Benjamin told the House.

After thanking the AOA House for allowing her to “interrupt” its deliberations, Dr. Benjamin stepped off the podium to a standing ovation. The House resumed work that afternoon on resolutions related to immunizations, salt consumption and breast-cancer screenings, among other preventive medicine policies.