Surgeon General of the United States

The Surgeon General of the United States is the operational head of the U.S. Public Health Service Commissioned Corps (PHSCC) and thus the leading spokesperson on matters of public health in the federal government of the United States. The Surgeon General's office and staff are known as the Office of the Surgeon General (OSG).

The U.S. Surgeon General is nominated by the President of the United States and confirmed by a majority vote of the Senate. The Surgeon General serves a four-year term of office and, depending on whether the current Assistant Secretary for Health is a PHSCC commissioned officer or not, is the senior or second-highest ranking uniformed officer of the PHSCC, holding the rank of a vice admiral. The current Acting Surgeon General is Rear Admiral Boris Lushniak, who was named to the position following Regina Benjamin's resignation on July 16, 2013.

Responsibilities
The Surgeon General reports to the Assistant Secretary for Health (ASH), who may be a four-star admiral in the United States Public Health Service, Commissioned Corps (PHSCC), and who serves as the principal adviser to the Secretary of Health and Human Services on public health and scientific issues. The Surgeon General is the overall head of the Commissioned Corps, a 6,500-member cadre of health professionals who are on call 24 hours a day, and can be dispatched by the Secretary of HHS or the Assistant Secretary for Health in the event of a public health emergency.

The Surgeon General is also the ultimate award authority for several public health awards and decorations, the highest of which that can be directly awarded is the Surgeon General's Medallion (the highest award bestowed by board action is the Public Health Service Distinguished Service Medal). The Surgeon General also has many informal duties, such as educating the American public about health issues and advocating healthy lifestyle choices.

The office also periodically issues health warnings. Perhaps the best known example of this is the "Surgeon General's Warning" labels that can be found on all packages of American tobacco cigarettes for 47 years. A similar health warning appears on alcoholic beverages labels, since 1988.

History
In 1798, Congress established the Marine Hospital Service—predecessor to today’s United States Public Health Service—to provide health care to sick and injured merchant seamen. In 1870, the Marine Hospital Service was reorganized as a national hospital system with centralized administration under a medical officer, the Supervising Surgeon, who was later given the title of Surgeon General.

The U.S. Public Health Service was under the direction of the Office of the Surgeon General and was an independent government agency until 1953 at which point it was integrated into the newly established United States Department of Health, Education, and Welfare, (HEW), and later in 1979/1980 into the reorganized United States Department of Health and Human Services (HHS).

Some Surgeons General are notable for being outspoken and advocating controversial proposals on how to reform the U.S. health system. The office is not a particularly powerful one, and has little direct statutary impact on policy-making, but Surgeons General are often vocal advocates (with 26th President Theodore Roosevelt's practice of "The Bully Pulpit" in the early 20th Century) of precedent-setting, far-sighted, unconventional or even unpopular health policies. With the advance of modern media, and an advanced medical establishment in America, the example of former Surgeon General, C. Everett Koop, during the administration of President Ronald Reagan in the 1980s or the attention paid to the controversial drive to confirm certain S.G. nominees by the U.S. Senate during the administration of Bill Clinton in the 1990s, shows just how truly powerful and influential an activist Surgeon General can be. Just like in comparison to the incumbent and office of the Vice President of the United States, the character, drive and reach of the office-holder makes the office itself, far more powerful or influential as they may be - "the man makes the job"!


 * On January 11, 1964, Rear Admiral Luther Leonidas Terry, M.D., published a landmark report saying that smoking may be hazardous to health, sparking nationwide anti-smoking efforts. Terry and his committee defined cigarette smoking of nicotine as not an addiction. (The committee itself consisted largely of physicians who themselves smoked.) This error went uncorrected for 24 years.
 * In 1986, Vice Admiral Dr. C. Everett Koop's report on AIDS called for some form of AIDS education in the early grades of elementary school, and gave full support for using condoms for disease prevention.
 * In 1994, Vice Admiral Dr. Joycelyn Elders had spoken at a United Nations conference on AIDS. She was asked whether it would be appropriate to promote masturbation as a means of preventing young people from engaging in riskier forms of sexual activity, and she replied, "I think that it is part of human sexuality, and perhaps it should be taught."

The U.S. Army, Navy, and Air Force also have officers overseeing medical matters in their respective services who hold the title Surgeon General.

The insignia of the Surgeon General, and the USPHS, use the caduceus as opposed to the Rod of Asclepius

Service rank
The Surgeon General is a commissioned officer in the U.S. Public Health Service, Commissioned Corps, one of the seven uniformed services of the United States, and by law holds the rank of vice admiral. Officers of the Public Health Service, Commissioned Corps are classified as non-combatants, but can be subjected to the Uniform Code of Military Justice (UCMJ) and the Geneva Conventions when designated by the Commander-in-Chief as a military force or if they are detailed or assigned to work with the armed forces. Officer members of these services wear uniforms that are similar to those worn by the United States Navy, except that the commissioning devices, buttons, and insignia are unique. Officers in the U.S. Public Health Service wear unique devices that are similar to U.S. Navy, Staff Corps Officers (e.g., Navy Medical Service Corps, Supply Corps, etc.).

The only Surgeon General to actually hold the rank of a four-star admiral was David Satcher,(b. 1941), (term: 1998-2002). This was because he served simultaneously in the positions of Surgeon General (three-star) and Assistant Secretary for Health (which is a four-star office). John Maynard Woodworth, (1837-1879), the first holder of the office as "Supervising Surgeon" (term: 1871-1879), is the only Surgeon General to not hold a rank.