Vivek Murthy, MD, Replaced as Surgeon General of America

The Trump administration removed Vivek Murthy, MD, on April 21 from his position as surgeon general in the middle of his 4-year term.

His temporary replacement is a nurse, Sylvia Trent-Adams, RN, PhD, formerly the deputy surgeon general.

The 39-year-old Dr Murthy was a holdover from the Obama administration who was confirmed by the Senate in a mostly party-line 51-to-43 vote in December 2014. The Department of Health and Human Services (HHS) announced that Dr Murthy was asked to resign and ""relieved of his duties"" after assisting the new administration in its transition. HHS Secretary Tom Price, MD, "thanks him for his dedicated service to the nation," according to the agency's news release, adding that Dr Murthy will continue to serve as a member of the US Public Health Service (USPHS) Commissioned Corps.
The USPHS Commissioned Corps and its 6600 uniformed health professionals are overseen by the surgeon general.

Surgeon generals have 4-year terms, and some have begun their term under one party's flag and finished it — or served out much of it — under another flag. The most recent example was former Surgeon General David Satcher, MD, PhD, a Bill Clinton appointee who completed his 4 years during the George W. Bush administration.

HHS did not give a reason why Dr Murthy was relieved of his duties. However, his track record holds some possible clues. Senate Republicans opposed his nomination in part because they viewed him as a political partisan. During the 2008 presidential election, Dr Murthy co-chaired a group called Doctors for Obama, and he later helped lead a successor group called Doctors for America that supported passage of the Affordable Care Act. He also incurred the wrath of the National Rifle Association and its congressional allies for declaring gun violence a public health issue.
Georges Benjamin, MD, the executive director of the American Public Health Association, said he was surprised by Dr Murthy's dismissal.

"I knew he anticipated completing his four years," Dr Benjamin told Medscape Medical News, noting that he had been in touch with Dr Murthy. "He was expecting to do that."
The Trump administration's removal of Dr Murthy "is another way of politicizing the job, which is inappropriate," said Dr Benjamin. "The reason why the surgeon general has a term is to depoliticize the position."
Efforts to reach Dr Murthy for an interview were unsuccessful. However, he did speak for himself in a post on his Facebook page. There, he said that he had been terminated for taking a principled stand.
"Many have asked why I chose not to resign as Surgeon General when I was asked to do so," he wrote. "My reason was simple: because I would never willfully abandon my commitment to my Commissioned Corps officers, to the American people, and to all who have stood with me to build a healthier and more compassionate America."

Lesson Learned: "Choose Love"

Before serving as surgeon general, Dr Murthy was a hospitalist at Brigham and Women's Hospital in Boston, Massachusetts, and an instructor in medicine at Harvard Medical School. He also cofounded a nonprofit group promoting HIV/AIDS education and a company that makes software for clinical trials.
One of Dr Murthy's top priorities as surgeon general was what he called "tobacco and drug-free living." To that end, he sent a letter to more than 1 million prescribers in November 2016 asking them to help battle the opioid epidemic, in part through better prescribing habits. Later that month, he released a major report on substance abuse that was likened to the surgeon general's landmark report on smoking issued in 1964.
In December 2016, Dr Murthy followed up with a report that called e-cigarettes a public health crisis for the nation's youth.
"I thought he was visible on the right issues," said the APHA's Dr Benjamin.
In another post on his Facebook page, Dr Murthy reflected on his brief tenure as surgeon general.

"For the grandson of a poor farmer from India to be asked by the president to look out for the health of an entire nation was a humbling and uniquely American story," he wrote. "While I had hoped to do more to help our nation tackle its biggest health challenges, I will be forever grateful for the opportunity to have served."
He listed a number of lessons he picked up on the job.

"We will only be successful in addressing addiction — and other illnesses — when we recognize the humanity within each of us," he wrote. "People are more than their disease. All of us are more than our worse mistakes."
And this: "The world is locked in a struggle between love and fear. Choose love. It is the world's oldest medicine."

Dr Murthy said the nation will be in "capable and compassionate hands" with Dr Trent-Adams taking over as acting surgeon general.
A 24-year veteran of the USPHS Commissioned Corps, Dr Trent-Adams has served as chief nursing officer of the USPHS and the deputy associate administrator for the HIV/AIDS Bureau in HHS. Before joining the USPHS Commissioned Corps, she was a nurse in the US Army and a research nurse at the University of Maryland.