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Not many health care leaders can transition smoothly from discussing the importance of walking 30 minutes per day to the need to send PHS officers to help control the Ebola epidemic in West Africa. The Surgeon General has to. As the most prominent public health official, the Surgeon General must offer a reassuring voice on health care issues big and small. With over 26 years at the PHS, Rear Admiral (RADM) Boris D. Lushniak, MD, MPH, is well equipped to handle the challenging role.
A year after assuming the role and just before delivering a plenary address at the 2014 AMSUS meeting, RADM Lushniak agreed to a wide-ranging conversation with Federal Practitioner. The following is condensed and edited, but the complete interview can be found at http://www.fedprac.com.
The 50th anniversary of the Surgeon General’s report on smoking
RADM Boris D. Lushniak, Acting Surgeon General. Go back to January 1964 and realize what a different world we lived in back then. In fact, that report, which came out after a year and a half of scientific deliberations, of looking at facts, of searching through the literature, came up with a very important conclusion. That conclusion, simply put was: Smoking is bad for you.
Now it really was a landmark report from that perspective, but when we look back 50 years, what did it prove? It proved that cigarette smoking was directly associated with only 1 cancer at that point, specifically lung cancer in men. The report had a very simple but beautiful conclusion. It said that cigarette smoking is a health hazard of significant importance in the U.S. to warrant appropriate remedial action....
A half-century later, the social norms of our society have changed. We don’t have ashtrays all around. We don’t smoke on airplanes anymore. We oftentimes can’t smoke in bars and restaurants and establishments like that. We’ve moved from 43% of our population that smoked in 1964 to 18% currently.
We’ve had 32 Surgeons’ General reports since that first one....We brought up the issue of secondhand smoke 25 years ago. We talked about the successes and failures over these years, but 50 years later smoking remains a major public health problem in this country....
When we look to the future, what’s the goal? Well we really want to get to a zero point. We reannounced with the 50th anniversary report, which was released in January 2014, that this is an endgame strategy. At some point we have to realize that it’s not good enough to get down to 18% because of the health impact. Cigarettes and tobacco use in this country bring no good; no good to the individual, no good to the individual who has to deal with secondhand smoke, and no good for the future of our nation. So we’re really talking about an endgame strategy....
Our 50th anniversary report wasn’t just looking backward....It contains current data that now show us that we’re up to 13 different cancers caused by tobacco use. We know the impact on the whole human body. In essence, it affects almost every single system of the human body now. Brand-new diseases, formerly not associated with smoking, are still being discovered.
Most recently, we’ve seen diabetes and colon and rectal cancers as some of those diseases. We’re talking about blindness associated with smoking. We’re talking about diseases such as erectile dysfunction, which are associated with smoking. This product has brought nothing but grief and sorrow into our society and continues to do so.
Now it’s not only an impact on the United States for the Office of the Surgeon General’s to speak, but also in essence we know that internationally people look at the Surgeon General reports that come out of this office as that stellar scientific information that then can be translated worldwide.
Not only do we see leadership of public health here within the United States, but we also see leadership on an international level by profiling some of the major public health issues.
The PHS response to Ebola in the U.S. and Africa
RADM Lushniak. As many of the readers may know, the Surgeon General is the commander of the U.S. Public Health Service Commissioned Corps. We have 6,800 public health professionals. These are officers working in 11 different categories working across the government, to protect, promote, and advance the health and safety of the nation.
[In October] I was in Anniston, Alabama, seeing about 70 of my officers being trained for deployment to Liberia. And in fact, in the next weeks, we will have a full team in Liberia who will be serving in the Monrovia Medical Unit and providing health care to both Liberian as well as foreign health care workers. I want to get that message out, because this battle against Ebola is occurring here in the U.S. and being done very well by the CDC and the NIH and elements of the Commissioned Corps who are working with the CDC.
At the same time, we know that the real success of eliminating Ebola and stopping the epidemic lies in Western Africa. Dr. Frieden has said that. We’re confident that there will not be an Ebola outbreak on U.S. soil; however, we need to be able to stop this outbreak. Therefore, I’m very proud of my officers who are heading off to Western Africa.
The role of the PHS Commissioned Corps
RADM Lushniak. Most of my officers are dedicated to who? To serving the underserved and vulnerable populations. Many of my clinical officers are assigned, for example, to the Indian Health Service and are providing care to that important population of our nation. They’re assigned to the Federal Bureau of Prisons and, therefore, working with the Department of Justice in getting health care to, again, a vulnerable and underserved population. They’re working at the NIH in a clinical perspective. They’re treating the Coast Guard as the main medical and dental and environment health officers. So I have officers scattered all around, and in essence, they see everything that any other practitioner sees in this country.
The emphasis certainly from the Office of the Surgeon General has been on prevention. It’s prevention of preventable diseases; many of them are chronic diseases. And certainly, my officers not only are out there treating those individual patients, but at the same time are implementing and taking to task on the importance of prevention as a general theme. We make sure that the word of the Surgeon General’s office gets spread to local communities through our practitioners.
Raising the Commissioned Corps profile
RADM Lushniak. We need to get the word out. Part of our issue, I’ll be honest with you, is that oftentimes people don’t even know the U.S. Public Health Service Commissioned Corps exists. Therefore, even when my officers are part of a Centers for Disease Control and Prevention response, they’re embedded with other facets of CDC.
What I want to proudly say is that right now this Monrovia Medical Unit will be run by U.S. Public Health Service Commissioned Corps. This is the only entity of the U.S. government that will actually have direct patient care responsibilities in Western Africa. That being said, we’re also proud that this year is the 125th anniversary of the Commissioned Corps as a uniformed service in this country. So 125 years ago an act was passed by Congress to be able to establish this uniformed service.
Finally, I’d like to say that no other nation has a uniformed service like this. I keep saying that I love my sister services. I love the Army, the Navy, the Air Force, the Marines, the Coast Guard; but many other nations have similar type entities.
The reality of the situation is that no other nation on this planet has a uniformed service purely dedicated to public health. We are an unarmed service, and we are part of the Department of Health and Human Services, but we are just as proud to be officers. We are just as proud to be serving our nation in uniform on a slightly different mission but one that has, again, a noble cause associated with it.
Reaching the top of the PHS
RADM Lushniak. I’m honored and humbled to be in this position at this stage of my career. I came in 26, almost 27 years ago into the United States Public Health Service as a young lieutenant. My goal at that time was to be an Epidemic Intelligence Service Officer at the Centers for Disease Control and Prevention. That’s how I started my career, doing what’s deemed to be shoe leather epidemiology, going out there and getting my hands dirty and being able to try to make this nation a better place and to protect the public’s health.
It’s been a great ride from the CDC to the FDA, and then ultimately, to the Office of the Secretary here within the Office of the Surgeon General as the Deputy and now as the Acting Surgeon General. The message is everyone should, first of all, acknowledge the fact that we have an incredible mission to undertake. The mission of the Commissioned Corps of the PHS is to protect, promote, and advance the health and safety of our nation. And I dare say although we captured that as our mission, that mission is translatable to almost every federal practitioner that is out there.
The burden of that is apparent—to protect, promote, and advance the health and safety of our nation. And yet it’s a bold and noble mission, one that is achievable. We’ve had incredible successes. We still have a lot of work ahead of us.
So first and foremost, I tell my young officers and I tell everyone who may be exposed to this conversation is the sense that do your job and do it well. That’s really the prime thing I’m asking my officers to do: Be dedicated to the mission and realize that incredible things are still achievable.
The National Prevention Strategy
The goal is for us to have a healthy population at every stage of life. And so 20 federal partners...came up with a National Prevention Strategy, which is a focus of priming our nation towards prevention and wellness. It’s based on 4 strategic aims, which includes the importance of healthy and safe communities. It also entails the idea of clinical community preventive services. It talks about the empowerment of people, which is a key component of change in this nation, and the elimination of health disparities throughout the nation. It focuses on the really important preventable diseases. And among them, include the elimination of tobacco use, the importance of our really looking at alcohol and substance use in general. It’s looking at the concept of active living, the importance that we move our bodies, and the importance of healthy eating.
Office of the Surgeon General initiatives
RADM Lushniak. First and foremost, the smoking issue still continues, and there will be more on tobacco use and smoking from us. We won’t give up that fight until we’re zeroed out.
In addition, recently we released a call to action on skin cancer prevention. That’s, I think, an important issue as well because we have over 5 million people in the United States each and every year who are treated for skin cancers. We have over 60,000 people who are diagnosed with the most deadly form of skin cancer, melanoma, and 9,000 people, that’s 1 person every hour, dying of melanoma. It has an incredible impact on our country, and it is, again, one of those preventable diseases. So we look at the idea of getting the message out that we, in the Office of Surgeon General, want people to live an active lifestyle. That’s an important part of the National Prevention Strategy.
I want people to be outdoors, I want them to be runners and walkers and enjoying nature; but at the same time, I need to get the message out that we need to be wary of ultraviolet radiation from sunlight, that we can protect ourselves, seek shade when possible, put on a big hat that produces shade on your face and neck and ears. Wear glasses, put on protective clothing, and then use sunscreens, broad-spectrum sunscreens of a UV protective factor of at least 15. That’s one of the initiatives that we recently released.
In the future, where we’re priming, we’re really getting back into the fitness mode. One of the things that we’re working on, and it really simplifies, I think, what has become too complex a message—the idea of how do we have a healthy and fit nation?...
I want people to start walking 30 minutes a day, 5 days a week. Do you realize just by that simple act of walking how good our nation could do in the future? How healthy we can be as a people. So we’re really looking at an emphasis on walking and walkable communities, because not every community is walkable at this stage.
Speaking at the AMSUS Continuing Education Meeting in Washington, D.C.
RADM Lushniak. AMSUS has always provided an excellent forum for the United States Public Health Service Commissioned Corps, of which I am the commander, to be able to share our information with other federal practitioners, with other parties within the federal family that are interested in health care, in public health, in contact with patients on the clinical side and the scientific side....
I’ve been a member over many years, and I’ve been a regular attendee at the meetings. It allows us to cross-fertilize, to have that ability to sit down with our sister services, to be able to sit down with nonuniformed professionals who serve in the federal system under the flag of health care or under the flag of medical care or under the big flag of science, medical science.
Not many health care leaders can transition smoothly from discussing the importance of walking 30 minutes per day to the need to send PHS officers to help control the Ebola epidemic in West Africa. The Surgeon General has to. As the most prominent public health official, the Surgeon General must offer a reassuring voice on health care issues big and small. With over 26 years at the PHS, Rear Admiral (RADM) Boris D. Lushniak, MD, MPH, is well equipped to handle the challenging role.
A year after assuming the role and just before delivering a plenary address at the 2014 AMSUS meeting, RADM Lushniak agreed to a wide-ranging conversation with Federal Practitioner. The following is condensed and edited, but the complete interview can be found at http://www.fedprac.com.
The 50th anniversary of the Surgeon General’s report on smoking
RADM Boris D. Lushniak, Acting Surgeon General. Go back to January 1964 and realize what a different world we lived in back then. In fact, that report, which came out after a year and a half of scientific deliberations, of looking at facts, of searching through the literature, came up with a very important conclusion. That conclusion, simply put was: Smoking is bad for you.
Now it really was a landmark report from that perspective, but when we look back 50 years, what did it prove? It proved that cigarette smoking was directly associated with only 1 cancer at that point, specifically lung cancer in men. The report had a very simple but beautiful conclusion. It said that cigarette smoking is a health hazard of significant importance in the U.S. to warrant appropriate remedial action....
A half-century later, the social norms of our society have changed. We don’t have ashtrays all around. We don’t smoke on airplanes anymore. We oftentimes can’t smoke in bars and restaurants and establishments like that. We’ve moved from 43% of our population that smoked in 1964 to 18% currently.
We’ve had 32 Surgeons’ General reports since that first one....We brought up the issue of secondhand smoke 25 years ago. We talked about the successes and failures over these years, but 50 years later smoking remains a major public health problem in this country....
When we look to the future, what’s the goal? Well we really want to get to a zero point. We reannounced with the 50th anniversary report, which was released in January 2014, that this is an endgame strategy. At some point we have to realize that it’s not good enough to get down to 18% because of the health impact. Cigarettes and tobacco use in this country bring no good; no good to the individual, no good to the individual who has to deal with secondhand smoke, and no good for the future of our nation. So we’re really talking about an endgame strategy....
Our 50th anniversary report wasn’t just looking backward....It contains current data that now show us that we’re up to 13 different cancers caused by tobacco use. We know the impact on the whole human body. In essence, it affects almost every single system of the human body now. Brand-new diseases, formerly not associated with smoking, are still being discovered.
Most recently, we’ve seen diabetes and colon and rectal cancers as some of those diseases. We’re talking about blindness associated with smoking. We’re talking about diseases such as erectile dysfunction, which are associated with smoking. This product has brought nothing but grief and sorrow into our society and continues to do so.
Now it’s not only an impact on the United States for the Office of the Surgeon General’s to speak, but also in essence we know that internationally people look at the Surgeon General reports that come out of this office as that stellar scientific information that then can be translated worldwide.
Not only do we see leadership of public health here within the United States, but we also see leadership on an international level by profiling some of the major public health issues.
The PHS response to Ebola in the U.S. and Africa
RADM Lushniak. As many of the readers may know, the Surgeon General is the commander of the U.S. Public Health Service Commissioned Corps. We have 6,800 public health professionals. These are officers working in 11 different categories working across the government, to protect, promote, and advance the health and safety of the nation.
[In October] I was in Anniston, Alabama, seeing about 70 of my officers being trained for deployment to Liberia. And in fact, in the next weeks, we will have a full team in Liberia who will be serving in the Monrovia Medical Unit and providing health care to both Liberian as well as foreign health care workers. I want to get that message out, because this battle against Ebola is occurring here in the U.S. and being done very well by the CDC and the NIH and elements of the Commissioned Corps who are working with the CDC.
At the same time, we know that the real success of eliminating Ebola and stopping the epidemic lies in Western Africa. Dr. Frieden has said that. We’re confident that there will not be an Ebola outbreak on U.S. soil; however, we need to be able to stop this outbreak. Therefore, I’m very proud of my officers who are heading off to Western Africa.
The role of the PHS Commissioned Corps
RADM Lushniak. Most of my officers are dedicated to who? To serving the underserved and vulnerable populations. Many of my clinical officers are assigned, for example, to the Indian Health Service and are providing care to that important population of our nation. They’re assigned to the Federal Bureau of Prisons and, therefore, working with the Department of Justice in getting health care to, again, a vulnerable and underserved population. They’re working at the NIH in a clinical perspective. They’re treating the Coast Guard as the main medical and dental and environment health officers. So I have officers scattered all around, and in essence, they see everything that any other practitioner sees in this country.
The emphasis certainly from the Office of the Surgeon General has been on prevention. It’s prevention of preventable diseases; many of them are chronic diseases. And certainly, my officers not only are out there treating those individual patients, but at the same time are implementing and taking to task on the importance of prevention as a general theme. We make sure that the word of the Surgeon General’s office gets spread to local communities through our practitioners.
Raising the Commissioned Corps profile
RADM Lushniak. We need to get the word out. Part of our issue, I’ll be honest with you, is that oftentimes people don’t even know the U.S. Public Health Service Commissioned Corps exists. Therefore, even when my officers are part of a Centers for Disease Control and Prevention response, they’re embedded with other facets of CDC.
What I want to proudly say is that right now this Monrovia Medical Unit will be run by U.S. Public Health Service Commissioned Corps. This is the only entity of the U.S. government that will actually have direct patient care responsibilities in Western Africa. That being said, we’re also proud that this year is the 125th anniversary of the Commissioned Corps as a uniformed service in this country. So 125 years ago an act was passed by Congress to be able to establish this uniformed service.
Finally, I’d like to say that no other nation has a uniformed service like this. I keep saying that I love my sister services. I love the Army, the Navy, the Air Force, the Marines, the Coast Guard; but many other nations have similar type entities.
The reality of the situation is that no other nation on this planet has a uniformed service purely dedicated to public health. We are an unarmed service, and we are part of the Department of Health and Human Services, but we are just as proud to be officers. We are just as proud to be serving our nation in uniform on a slightly different mission but one that has, again, a noble cause associated with it.
Reaching the top of the PHS
RADM Lushniak. I’m honored and humbled to be in this position at this stage of my career. I came in 26, almost 27 years ago into the United States Public Health Service as a young lieutenant. My goal at that time was to be an Epidemic Intelligence Service Officer at the Centers for Disease Control and Prevention. That’s how I started my career, doing what’s deemed to be shoe leather epidemiology, going out there and getting my hands dirty and being able to try to make this nation a better place and to protect the public’s health.
It’s been a great ride from the CDC to the FDA, and then ultimately, to the Office of the Secretary here within the Office of the Surgeon General as the Deputy and now as the Acting Surgeon General. The message is everyone should, first of all, acknowledge the fact that we have an incredible mission to undertake. The mission of the Commissioned Corps of the PHS is to protect, promote, and advance the health and safety of our nation. And I dare say although we captured that as our mission, that mission is translatable to almost every federal practitioner that is out there.
The burden of that is apparent—to protect, promote, and advance the health and safety of our nation. And yet it’s a bold and noble mission, one that is achievable. We’ve had incredible successes. We still have a lot of work ahead of us.
So first and foremost, I tell my young officers and I tell everyone who may be exposed to this conversation is the sense that do your job and do it well. That’s really the prime thing I’m asking my officers to do: Be dedicated to the mission and realize that incredible things are still achievable.
The National Prevention Strategy
The goal is for us to have a healthy population at every stage of life. And so 20 federal partners...came up with a National Prevention Strategy, which is a focus of priming our nation towards prevention and wellness. It’s based on 4 strategic aims, which includes the importance of healthy and safe communities. It also entails the idea of clinical community preventive services. It talks about the empowerment of people, which is a key component of change in this nation, and the elimination of health disparities throughout the nation. It focuses on the really important preventable diseases. And among them, include the elimination of tobacco use, the importance of our really looking at alcohol and substance use in general. It’s looking at the concept of active living, the importance that we move our bodies, and the importance of healthy eating.
Office of the Surgeon General initiatives
RADM Lushniak. First and foremost, the smoking issue still continues, and there will be more on tobacco use and smoking from us. We won’t give up that fight until we’re zeroed out.
In addition, recently we released a call to action on skin cancer prevention. That’s, I think, an important issue as well because we have over 5 million people in the United States each and every year who are treated for skin cancers. We have over 60,000 people who are diagnosed with the most deadly form of skin cancer, melanoma, and 9,000 people, that’s 1 person every hour, dying of melanoma. It has an incredible impact on our country, and it is, again, one of those preventable diseases. So we look at the idea of getting the message out that we, in the Office of Surgeon General, want people to live an active lifestyle. That’s an important part of the National Prevention Strategy.
I want people to be outdoors, I want them to be runners and walkers and enjoying nature; but at the same time, I need to get the message out that we need to be wary of ultraviolet radiation from sunlight, that we can protect ourselves, seek shade when possible, put on a big hat that produces shade on your face and neck and ears. Wear glasses, put on protective clothing, and then use sunscreens, broad-spectrum sunscreens of a UV protective factor of at least 15. That’s one of the initiatives that we recently released.
In the future, where we’re priming, we’re really getting back into the fitness mode. One of the things that we’re working on, and it really simplifies, I think, what has become too complex a message—the idea of how do we have a healthy and fit nation?...
I want people to start walking 30 minutes a day, 5 days a week. Do you realize just by that simple act of walking how good our nation could do in the future? How healthy we can be as a people. So we’re really looking at an emphasis on walking and walkable communities, because not every community is walkable at this stage.
Speaking at the AMSUS Continuing Education Meeting in Washington, D.C.
RADM Lushniak. AMSUS has always provided an excellent forum for the United States Public Health Service Commissioned Corps, of which I am the commander, to be able to share our information with other federal practitioners, with other parties within the federal family that are interested in health care, in public health, in contact with patients on the clinical side and the scientific side....
I’ve been a member over many years, and I’ve been a regular attendee at the meetings. It allows us to cross-fertilize, to have that ability to sit down with our sister services, to be able to sit down with nonuniformed professionals who serve in the federal system under the flag of health care or under the flag of medical care or under the big flag of science, medical science.
Not many health care leaders can transition smoothly from discussing the importance of walking 30 minutes per day to the need to send PHS officers to help control the Ebola epidemic in West Africa. The Surgeon General has to. As the most prominent public health official, the Surgeon General must offer a reassuring voice on health care issues big and small. With over 26 years at the PHS, Rear Admiral (RADM) Boris D. Lushniak, MD, MPH, is well equipped to handle the challenging role.
A year after assuming the role and just before delivering a plenary address at the 2014 AMSUS meeting, RADM Lushniak agreed to a wide-ranging conversation with Federal Practitioner. The following is condensed and edited, but the complete interview can be found at http://www.fedprac.com.
The 50th anniversary of the Surgeon General’s report on smoking
RADM Boris D. Lushniak, Acting Surgeon General. Go back to January 1964 and realize what a different world we lived in back then. In fact, that report, which came out after a year and a half of scientific deliberations, of looking at facts, of searching through the literature, came up with a very important conclusion. That conclusion, simply put was: Smoking is bad for you.
Now it really was a landmark report from that perspective, but when we look back 50 years, what did it prove? It proved that cigarette smoking was directly associated with only 1 cancer at that point, specifically lung cancer in men. The report had a very simple but beautiful conclusion. It said that cigarette smoking is a health hazard of significant importance in the U.S. to warrant appropriate remedial action....
A half-century later, the social norms of our society have changed. We don’t have ashtrays all around. We don’t smoke on airplanes anymore. We oftentimes can’t smoke in bars and restaurants and establishments like that. We’ve moved from 43% of our population that smoked in 1964 to 18% currently.
We’ve had 32 Surgeons’ General reports since that first one....We brought up the issue of secondhand smoke 25 years ago. We talked about the successes and failures over these years, but 50 years later smoking remains a major public health problem in this country....
When we look to the future, what’s the goal? Well we really want to get to a zero point. We reannounced with the 50th anniversary report, which was released in January 2014, that this is an endgame strategy. At some point we have to realize that it’s not good enough to get down to 18% because of the health impact. Cigarettes and tobacco use in this country bring no good; no good to the individual, no good to the individual who has to deal with secondhand smoke, and no good for the future of our nation. So we’re really talking about an endgame strategy....
Our 50th anniversary report wasn’t just looking backward....It contains current data that now show us that we’re up to 13 different cancers caused by tobacco use. We know the impact on the whole human body. In essence, it affects almost every single system of the human body now. Brand-new diseases, formerly not associated with smoking, are still being discovered.
Most recently, we’ve seen diabetes and colon and rectal cancers as some of those diseases. We’re talking about blindness associated with smoking. We’re talking about diseases such as erectile dysfunction, which are associated with smoking. This product has brought nothing but grief and sorrow into our society and continues to do so.
Now it’s not only an impact on the United States for the Office of the Surgeon General’s to speak, but also in essence we know that internationally people look at the Surgeon General reports that come out of this office as that stellar scientific information that then can be translated worldwide.
Not only do we see leadership of public health here within the United States, but we also see leadership on an international level by profiling some of the major public health issues.
The PHS response to Ebola in the U.S. and Africa
RADM Lushniak. As many of the readers may know, the Surgeon General is the commander of the U.S. Public Health Service Commissioned Corps. We have 6,800 public health professionals. These are officers working in 11 different categories working across the government, to protect, promote, and advance the health and safety of the nation.
[In October] I was in Anniston, Alabama, seeing about 70 of my officers being trained for deployment to Liberia. And in fact, in the next weeks, we will have a full team in Liberia who will be serving in the Monrovia Medical Unit and providing health care to both Liberian as well as foreign health care workers. I want to get that message out, because this battle against Ebola is occurring here in the U.S. and being done very well by the CDC and the NIH and elements of the Commissioned Corps who are working with the CDC.
At the same time, we know that the real success of eliminating Ebola and stopping the epidemic lies in Western Africa. Dr. Frieden has said that. We’re confident that there will not be an Ebola outbreak on U.S. soil; however, we need to be able to stop this outbreak. Therefore, I’m very proud of my officers who are heading off to Western Africa.
The role of the PHS Commissioned Corps
RADM Lushniak. Most of my officers are dedicated to who? To serving the underserved and vulnerable populations. Many of my clinical officers are assigned, for example, to the Indian Health Service and are providing care to that important population of our nation. They’re assigned to the Federal Bureau of Prisons and, therefore, working with the Department of Justice in getting health care to, again, a vulnerable and underserved population. They’re working at the NIH in a clinical perspective. They’re treating the Coast Guard as the main medical and dental and environment health officers. So I have officers scattered all around, and in essence, they see everything that any other practitioner sees in this country.
The emphasis certainly from the Office of the Surgeon General has been on prevention. It’s prevention of preventable diseases; many of them are chronic diseases. And certainly, my officers not only are out there treating those individual patients, but at the same time are implementing and taking to task on the importance of prevention as a general theme. We make sure that the word of the Surgeon General’s office gets spread to local communities through our practitioners.
Raising the Commissioned Corps profile
RADM Lushniak. We need to get the word out. Part of our issue, I’ll be honest with you, is that oftentimes people don’t even know the U.S. Public Health Service Commissioned Corps exists. Therefore, even when my officers are part of a Centers for Disease Control and Prevention response, they’re embedded with other facets of CDC.
What I want to proudly say is that right now this Monrovia Medical Unit will be run by U.S. Public Health Service Commissioned Corps. This is the only entity of the U.S. government that will actually have direct patient care responsibilities in Western Africa. That being said, we’re also proud that this year is the 125th anniversary of the Commissioned Corps as a uniformed service in this country. So 125 years ago an act was passed by Congress to be able to establish this uniformed service.
Finally, I’d like to say that no other nation has a uniformed service like this. I keep saying that I love my sister services. I love the Army, the Navy, the Air Force, the Marines, the Coast Guard; but many other nations have similar type entities.
The reality of the situation is that no other nation on this planet has a uniformed service purely dedicated to public health. We are an unarmed service, and we are part of the Department of Health and Human Services, but we are just as proud to be officers. We are just as proud to be serving our nation in uniform on a slightly different mission but one that has, again, a noble cause associated with it.
Reaching the top of the PHS
RADM Lushniak. I’m honored and humbled to be in this position at this stage of my career. I came in 26, almost 27 years ago into the United States Public Health Service as a young lieutenant. My goal at that time was to be an Epidemic Intelligence Service Officer at the Centers for Disease Control and Prevention. That’s how I started my career, doing what’s deemed to be shoe leather epidemiology, going out there and getting my hands dirty and being able to try to make this nation a better place and to protect the public’s health.
It’s been a great ride from the CDC to the FDA, and then ultimately, to the Office of the Secretary here within the Office of the Surgeon General as the Deputy and now as the Acting Surgeon General. The message is everyone should, first of all, acknowledge the fact that we have an incredible mission to undertake. The mission of the Commissioned Corps of the PHS is to protect, promote, and advance the health and safety of our nation. And I dare say although we captured that as our mission, that mission is translatable to almost every federal practitioner that is out there.
The burden of that is apparent—to protect, promote, and advance the health and safety of our nation. And yet it’s a bold and noble mission, one that is achievable. We’ve had incredible successes. We still have a lot of work ahead of us.
So first and foremost, I tell my young officers and I tell everyone who may be exposed to this conversation is the sense that do your job and do it well. That’s really the prime thing I’m asking my officers to do: Be dedicated to the mission and realize that incredible things are still achievable.
The National Prevention Strategy
The goal is for us to have a healthy population at every stage of life. And so 20 federal partners...came up with a National Prevention Strategy, which is a focus of priming our nation towards prevention and wellness. It’s based on 4 strategic aims, which includes the importance of healthy and safe communities. It also entails the idea of clinical community preventive services. It talks about the empowerment of people, which is a key component of change in this nation, and the elimination of health disparities throughout the nation. It focuses on the really important preventable diseases. And among them, include the elimination of tobacco use, the importance of our really looking at alcohol and substance use in general. It’s looking at the concept of active living, the importance that we move our bodies, and the importance of healthy eating.
Office of the Surgeon General initiatives
RADM Lushniak. First and foremost, the smoking issue still continues, and there will be more on tobacco use and smoking from us. We won’t give up that fight until we’re zeroed out.
In addition, recently we released a call to action on skin cancer prevention. That’s, I think, an important issue as well because we have over 5 million people in the United States each and every year who are treated for skin cancers. We have over 60,000 people who are diagnosed with the most deadly form of skin cancer, melanoma, and 9,000 people, that’s 1 person every hour, dying of melanoma. It has an incredible impact on our country, and it is, again, one of those preventable diseases. So we look at the idea of getting the message out that we, in the Office of Surgeon General, want people to live an active lifestyle. That’s an important part of the National Prevention Strategy.
I want people to be outdoors, I want them to be runners and walkers and enjoying nature; but at the same time, I need to get the message out that we need to be wary of ultraviolet radiation from sunlight, that we can protect ourselves, seek shade when possible, put on a big hat that produces shade on your face and neck and ears. Wear glasses, put on protective clothing, and then use sunscreens, broad-spectrum sunscreens of a UV protective factor of at least 15. That’s one of the initiatives that we recently released.
In the future, where we’re priming, we’re really getting back into the fitness mode. One of the things that we’re working on, and it really simplifies, I think, what has become too complex a message—the idea of how do we have a healthy and fit nation?...
I want people to start walking 30 minutes a day, 5 days a week. Do you realize just by that simple act of walking how good our nation could do in the future? How healthy we can be as a people. So we’re really looking at an emphasis on walking and walkable communities, because not every community is walkable at this stage.
Speaking at the AMSUS Continuing Education Meeting in Washington, D.C.
RADM Lushniak. AMSUS has always provided an excellent forum for the United States Public Health Service Commissioned Corps, of which I am the commander, to be able to share our information with other federal practitioners, with other parties within the federal family that are interested in health care, in public health, in contact with patients on the clinical side and the scientific side....
I’ve been a member over many years, and I’ve been a regular attendee at the meetings. It allows us to cross-fertilize, to have that ability to sit down with our sister services, to be able to sit down with nonuniformed professionals who serve in the federal system under the flag of health care or under the flag of medical care or under the big flag of science, medical science.