CNN journalist lacks independent voice to be surgeon general

The prospect of Dr. Sanjay Gupta applying his skills as spokesman in the service of Obama's agenda is a source of concern.

WASHINGTON - At 39, Sanjay Gupta is an assistant professor at Emory University Medical School and associate chief of neurosurgery at Atlanta's Grady Memorial Hospital, a large full-service medical center that is also the city's public hospital. Those are fine credentials for a young doctor, but not enough by themselves to make him a national leader in medicine, let alone leading the short list for surgeon general.

But multiple news organizations last week confirmed that Gupta is President-elect Barack Obama's top choice to be surgeon general, which oversees the nation's public-health force and serves as national physician in chief, issuing public warnings about health risks.

Some reports noted that Obama is also planning to ask Gupta to play an outreach role in helping Health and Human Services Secretary-designate Tom Daschle overhaul the nation's health system.

This latter job seems like an outgrowth of the talents Gupta has displayed as the medical correspondent for CNN - the credential that seems to have vaulted him to the top of Obama's list. Gupta also has some political experience, having written speeches for Hillary Clinton during her failed attempt to remake the health system in 1993.

Likable and straightforward, with an unflappable but warm manner, Gupta seems like the kind of doctor in whom anyone could confide a painful or embarrassing medical problem, trusting that he would be both sensitive and professional. And then, when the camera comes on, he can skillfully toggle into a discussion of the asthma epidemic in inner cities, or how new education techniques are helping children with autism.

The problem - as a small but growing chorus of critics points out - is that the surgeon general isn't merely a communicator, but a policy maker who is supposed to be an independent voice on medical matters. And the prospect of Gupta applying his CNN-honed skills as a spokesman in the service of Obama's agenda is a bit of a concern, especially in an administration top-heavy with politicians but relatively short, by historical standards, on senior figures with independent expertise.

Not all surgeons general have been towering figures, but some have. And most have conceived of their job as detached from politics: Their greater allegiance is to medicine, and to maintaining a kind of doctor-patient relationship with the public.

Ronald Reagan's surgeon general, C. Everett Koop, came into office with far more experience and significantly greater credentials than Gupta, having served for 35 years as surgeon in chief at the Children's Hospital of Philadelphia, one of the nation's leading teaching hospitals for pediatric surgery. Still, many people worried that Koop, who had spoken out against abortion, was too political a choice.

And when Reagan, who opposed abortion rights, insisted that Koop deliver a report on the possible health ramifications of abortion on women, many of Koop's critics feared that he would draw conclusions helpful to abortion-rights opponents. Instead, he offered a scientific conclusion that there was no conclusively reliable follow-up research on women who'd had abortions, and declined to declare that abortions are a potential danger to women's health.

Likewise, when the Reagan administration was keeping its distance from the incipient AIDS crisis, which cast an uncomfortable spotlight on gay sex, Koop declared a public-health crisis was at hand, and insisted that the public receive detailed information on how to avoid getting AIDS. His actions raised the ire of some gay groups as well as many conservatives, who thought the matter inappropriate for public discussion. But Koop conceived of himself as a medical professional, not a politician.

Gupta may well feel the same way, and could easily surprise his critics the way that Koop defied his. But it's instinctively easier to imagine that a doctor who helped lead a major hospital for four decades, functioning exclusively in the realm of the medical profession, could simply brush aside political concerns, more than a doctor who chose to work in politics and journalism.

John Conyers, the 79-year-old chairman of the House Judiciary Committee, is rallying opposition to Gupta, citing his relatively young age and lack of experience. But Conyers's opposition may be a bit calculated; he has been pushing a Detroit public-health official for the post, and seems bruised by Obama's apparent preference for Gupta.

In choosing the young, charismatic, and politically astute doctor, Obama is hoping for a little star appeal to help push his medical agenda. But Gupta, who is said to be weighing the job, would be wise to declare his independence from the Obama administration before announcing his preference for the job.

Peter S. Canellos is the Globe's Washington bureau chief. National Perspective is his weekly analysis of events in the capital and beyond. He can be reached at canellos@globe.com