New Surgeon General on Way to Confirmation

Known by some for his daredevil antics, Dr. Richard Carmona, President Bush's nominee for surgeon general, appeared a step closer to having a smooth confirmation on Tuesday. 

I'm confident you'll be confirmed," Sen. Edward Kennedy, D-Mass, chairman of the Senate Health, Education, Labor, and Pensions Committee, told Carmona.

When nominated for surgeon general, Carmona was praised as a Green Beret turned trauma surgeon who took chances, once dangling from a helicopter in a mountainside rescue.  

At Tuesday's hearing, Carmona vowed to discourage smoking and agreed with Kennedy that tobacco companies market cigarettes to children. Although most public health experts argue that guns are a threat to the public, Carmona suggested he would not take sides in the debate, but try to bring the parties together.

He also said he would focus on preparing the nation against threats of bioterrorism.

"Most physicians have not had significant training needed," he said.

Despite the impending confirmation, questions have been raised about his employment record.  He did not argue with reports that said it took him eight years to win board certification in his field, general surgery, and that he failed the exam twice.

"I don't think anyone has ever questioned my ability," he told Kennedy. He said he passed the test within the window allowed by the board.

Carmona also dismissed reports that he brings a confrontational style to his work. He said he has been "an agent of change" in leadership positions, improving systems that he led.

"At times that's upsetting to people who live in the status quo," he said. "Those who do step out may be characterized as confrontational. I always treated my patients, staff and co-workers with respect."

But one of Carmona's colleagues questioned his ability to play well with others. University of Arizona Dr. Charles W. Putnam said in a letter to Kennedy that Carmona was unfit for the job due to his lack of experience in health policy and "concerns about character issues," including an inability to work "in an effective or even a civil manner" with others.

Putnam also argued that Carmona's work on a sheriff's SWAT team was in direct conflict with his duty as a physician to "do no harm."

In his letter, Putnam singled out an incident that Bush and other supporters have cited as a shining moment.

In 1999, Carmona spotted one driver assaulting another after a car accident and intervened. Shot at, Carmona fired back and -- as the administration tells it -- tried to stanch the man's ultimately fatal wound. The assailant, who was mentally ill, turned out to have been a murder suspect who had stabbed his father to death that day.

However, some reports indicated that Carmona had acted differently. The Los Angeles Times quoted a police interview with Carmona at the scene indicating that, in fact, he did not try to save the man after shooting him but went to his car to reload his revolver.

Putman questioned whether his action was fitting for a surgeon general.

"Whatever the precise circumstances of that encounter ... it is patently clear that Sheriff Carmona ... not Dr. Carmona was at center stage in that emergency. Could not a physician have recognized the behavior of a mentally ill individual and responded in kind?" he wrote.

Others in public health share this concern.

"Am I proud that our surgeon general (nominee) shoots people? ... I don't find that inspiring," Dr. James Curran, dean of the Emory School of Public Health, said in an interview. He predicted that the administration would regret the nomination. "This guy is a cowboy."

Kennedy planned a committee vote for later this month, though all nominations before the full Senate are on hold due to an unrelated manner.

The Associated Press contributed to this report.