Army’s Surgeon General Not a Doctor

Lt. Gen. Patricia Horoho is the first woman and first nonphysician to become the Army’s surgeon general.   Lt. Gen. Horoho is a nurse.  I know this is a controversial topic and will get some people pissed (on both sides) but it seems to me that we need to start doing a better job defining certain professions.   A surgeon general, I guess, now does not have to be a surgeon nor a doctor.    Don’t get me wrong, this person has an impressive resume as you can see here.    Here is a little background on the title of Army Surgeon General according to Wikipedia:

 Congress established the Medical Service of the Continental Army on July 27, 1775 and emplaced a “Chief physician & director general” of the Continental Army as its head at that time. The first five “surgeons general” of the U.S. Army served under this title. An Act of May 28, 1789 established a “Physician general” of the U.S. Army (only Doctors Richard Allison and James Craik served according to this nomenclature). An Act of March 13, 1813 cited the “Physician & surgeon general” of the U.S. Army. This nomenclature remained in place until the Medical Department was established by the Reorganization Act of April 14, 1818.  He or she is responsible for development, policy direction, organization and overall management of an integrated Army-wide health service system and is the medical materiel developer for the Army.  These duties include formulating policy regulations on health service support, health hazard assessment and the establishment of health standards.

So what does this mean? Really nothing.  This is an administrative job, plain and simple.    I think they need to rename the title or else confuse more and more people about what doctors do and are.   My medical partner is a former Army guy.  He says this is not a male or female thing.  This is an issue of different professions trying to encroach more and more onto physician territory.   Maybe now it is nurse but maybe a few years it is a medic.  At what point is there or should there be a line in the sand?   I await your thoughts.

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  7 comments for “Army’s Surgeon General Not a Doctor

  1. Scott
    January 20, 2012 at 3:41 pm

    The military has a hard time keeping doctors (MDs, DOs). The DOD doesn’t pay much, deployments blow, and they refuse to treat doctors like anything special. As a result, doctors tend seek greener pastures. I was Air Force for 7 years for my USUHS committment and got out as soon as I could.

    Most of my commanders in the Air Force were nurses. They were the only ones willing to do the job, and for the most part they did it well. Most doctors aren’t willing to abandon clinical practice for the demands of command.

    So it makes perfect sense to me for a nurse to be the surgeon general. Maybe if the military treated doctors better, more would stay on active duty, and would rise to the level of command.

  2. Jim
    January 18, 2012 at 10:42 pm

    This is outrageous. No nurse should ever be named to this position (or PA/NP for that matter).

    You can bet no paralegal will be named Attourney General.

    Here’s a thought, if you are not a doctor you can’t be called doctor nor have their job, if you are not a nurse you can’t do the job of a nurse, and if your not a lawyer you can’t do the job of a lawyer etc etc. I know, it makes too much sense, but what ever happened to having eaned a title and position?

    I don’t want my doctor representing me in a court of law, nor trying to get my IV pump to work and I don’t want my nurse trying to play doctor.

    But the powers that be (Oprama) want nurses and doctors to be “equal” and they are trying their best to accomplish that with policy.

  3. Rhonda
    January 18, 2012 at 10:28 pm

    I’ll go ahead and admit first-off…I’m an RN! I subscribe to this e-newsletter because I find there are many relevant topics to nursing as well. It’s also completely uncensored, which is such a relief in this era of politcially correct, to hell with common sense, drivel.

    Now, if you’re still reading my comment after learning I’m a nurse, good for you. I agree that the nomeclature used to describe this position is completely misleading and does cause confusion. Is it even legal? I can’t present myself as a physician anymore than the housekeeper mopping up the blood in the ER last Friday night (flashbacks from a severed arm, sorry) could present himself as a nurse. I cannot speak for every other nurse out there, but I sure don’t want to be confused with a physician (contrary to popular belief, I am not a nurse because I couldn’t make it as a physician). I do believe this position can be filled by a nurse (once the title of the position is changed)based on the job description provided in the article and I will gladly explain why. Of course, I will do so briefly because I have about as little time as any of you. The person most qualified for a position like this needs to be someone familiar and competent with all aspects of delivering healthcare (clincial, administrative, economic). Some nurses and physicians have these qualifications, some do not.

    Regarding some of the other comments, I would like to add my thoughts. As an RN, I see unlicensed personnel being referred to as nurses frequently because they have on scrubs (yes, our housekeepers decided they wanted to wear gray scrubs and now our patients who can’t read itty bitty name badges don’t know who’s who). The clinic associated with my hospital (and also where I receive care for my family) has decided, and it’s legal, that the gal who was checking my groceries last week can be delegated nursing responsibilities in the office because it’s under “direct” physician supervision. These people are also being referred to as nurses by the patients and the patients are not always corrected by the unlicensed personnel. It is frustrating that a profession I worked so hard to enter and I’ve dedicated my life to can be treated so flippantly. Perhaps this is what physicians feel like when someone mistakes a nurse for a doctor. Regarding the small town physicians attitudes toward midlevels, well, I’m going to go out on a limb and say that our physicians have benefitted greatly from the NP’s and PA’s taking first ER call at night, weekends, and holidays(the docs asked for this arrangement and NP’s were once lowly staff nurses who didn’t know some people can choose to work Monday-Friday,8-5 so it’s no skin off their teeth). It’s not easy recruiting physicians to rural communities and sometimes, midlevels are the only way to provide healthcare.

    Instead of the proverbial Nurse/Doctor antagonism, let’s focus on the fact that BOTH disciplines are needed to provide quality (yes, I said a naughty word) healthcare and are BOTH being stifled by rules, regulations, and politically correct idiots who don’t know (or don’t care)that you can’t call a nurse a surgeon because it’s just plain silly.

  4. Michael
    January 18, 2012 at 1:27 pm

    They need to change the name of the post. I am tired of hearing PA’s and RN’s being addressed by patients as “doctor” in spite of not having an advanced degree. The “doctor of nursing” is also very misleading to patients, as they do not understand what the limitations on RN’s, doctorate or not, under nursing practice acts.

    The creep of “scope of practice” is unbelievable. We recently had a proposal by a group to have nursing in the ED place central lines, do intubations and chest tubes. Luckily, it did not make it past credentials committee. In my mind it was incredible that it even got to credentials committee, as none had the education, training and demonstrated clinical competence to do any of these procedures.

  5. January 14, 2012 at 2:17 am

    As in so many other areas, the military leads the way … In blurring lines for political expediency. I’m a 10-year veteran of naval aviation, and saw from the start how females were often given extra breaks in flight training; later I saw the coming storm as the gals were being foisted into combat slots, with all the inherent disruption of morale, standards, and – yes – good times when women are mandated into the locker room.

    No, I’m not on a sexist rant (for starters, I’m a proud chauvinist, and there IS a difference). But the military loves to embrace whatever stupid PC idea is blowing, and they for more than two decades have been proving it by giving minimally trained enlisted folks menial positional authority over officers over the silliest things. Now the Pentagon has given us a “nurse-doctor” as a headline policy maker, reducing further the value, expertise, or worth of physicians in the public mind, military or civilian.

    Think I’m making too much of it? Go talk to any rural family doc in competition with non-docs, and extrapolate the fudging of roles to a stage writ larger and dumber.

  6. Griff
    January 13, 2012 at 4:28 pm

    Met her in Afghanistan. Very capable woman. I have no issues with her being Surgeon General as long as everyone can understand the the SG of all the services is a policy maker and rarely performs as a physician. I do feel that having a doctor as a policy writer decreases the BS factor of some of the stuff that drops from the Adminisphere.

    • panacea
      January 19, 2012 at 10:10 pm

      The initials AFTER MG Horoho’s name are the issue.

      The title of SURGEON is truly in name only and does not accurately define that this is an adminisphere position.
      To anyone outside the military medical world (and likely some in it), they see the news ticker headline and must think ‘we’ have lost our minds and all control.

      MG Horoho is extremely qualified for an admin position at this level, so I vote she can keep it, as long as we RENAME it Health Care Policy General.

      Disclaimer: I am a female Active Duty Army physician, and my above views do not reflect the opinion of the DoD.

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