America is in the midst of one of the greatest health care crises we have seen in decades. At this critical moment, it is frightening that there is no individual in the role of surgeon general taking responsibility for managing the situation.
Dr. Vivek Murthy was nominated for the Surgeon General position last year but his nomination has been held up in Congress indefinitely.
It’s time the White House identifies someone else, whom everyone can agree on, to fill this critically important role, and it needs to happen now. The skills required for this surgeon general include not only deep medical expertise but incredibly sharp communication and management skills.
The surgeon general is supposed to be the lead communicator and spokesman for public health issues in the U.S. His or her key responsibilites are to communicate clearly and instill confidence in the public about health issues, especially one as significant as the Ebola crisis.
One of the key factors in the rapid spread of Ebola is the lack of leadership in the surgeon general role and a clear plan of communication and execution.
The lessons I’ve learned as a surgeon can be applied to handling the present situation. When there is a crisis during surgery, there is a systematic approach to how every doctor deals with the situation to prevent chaos and adverse outcomes.
1. Isolate the problem. It’s crucial that health professionals are able to isolate individuals at risk and create a plan to prevent further exposure to others. If there is a blood vessel that has ruptured during surgery, your first step is to isolate the bleeder and prevent it from causing damage to other tissues.
2. Taking control of the situation. In the operating room the surgeon will dictate the steps to be carried out in an adverse event and communicate the plan to everyone there, including the nurse and the anesthesiologist. There is no consensus-building in the operating room about how to treat the ruptured blood vessel. Similarly, in handing the Ebola crisis, the surgeon general should define a clear plan of action and communicate that to all the stakeholders involved.
3. A clear plan of action. The best surgeons are those who have seen the most complications. If you haven’t experienced complications, you aren’t operating enough. The measure of a truly skilled surgeon is his ability to respond to a crisis with a well-defined plan based on the experience gained from previous crises. That is the kind of individual we need in the surgeon general role.
4. Collaboration. In the operating room a surgeon would be helpless without a skilled nursing staff that is trained to anticipate his next move, as well as an anesthesiologist who can do the same. Similarly, the U.S. desperately needs a surgeon general with a defined plan that can be coordinated with the CDC, USAID, WHO, NIH and every health care professional and other key stakeholders, as opposed to the current three-ring circus.
5. Communication. A surgeon who doesn’t communicate to the nursing staff and the anesthesiologist is going to find himself in dire straits without any support in executing his plan of action. Since the surgeon general is supposed to be our lead health care communicator, we desperately need an individual who is adept not just in the science of medicine, but in the ability to effectively communicate the issue at hand and how it will be dealt with. The communication plan should be so effective that even a 5-year old could understand it.
6. Data. There is nothing more important than constantly monitoring the situation, using technology and data to provide real-time feedback to stakeholders and the public. Managing a crisis without effective data would be like performing surgery with no monitors in the room.
If ever the United States needed a physician-leader, it’s now. It’s unacceptable to expect that the public should lose confidence or be misguided on Ebola, one of the most serious health issues lurking in the United States.