Should a psychiatrist be the “Nation’s Doctor”?
PSYCHIATRIC VIEWS ON THE DAILY NEWS
The US Surgeon General is the highest governmental position for a physician. Whoever serves in the position is known as the “Nation’s Doctor.” Although the specialist term Surgeon is used, the physician need not be a surgeon and usually is not.
However, psychiatrists are physicians, but have never been a US Surgeon General. That omission is despite the fact that so much of health care has a crucial psychological component.
Certainly, a nonpsychiatrist can pay attention to mental health. Our current one is doing just that as far as the deterioration in adolescent mental health goes. These questions remain, though. How far will his general psychiatric expertise take him, and us? Has he been consulting with psychiatrists?
The pandemic years have also had their own important mental health aspects: the denial and delay of responding to the crisis; the poor messaging to the public; and the rise in all kinds of undue psychological symptoms.
During President Trump’s term, the question of whether a confidential mental health assessment is needed for anyone running for President, as well as yearly mental check-ups of whoever is elected, received serious attention. Who better to take responsibility for that than a US Surgeon General who is a psychiatrist?
In a recent presentation I made to psychodynamic psychiatrists about our social psychiatric problems, a challenging attendee asked: when has a psychiatrist successfully participated with politicians at the highest levels? One obvious example is Jerrold Post, MD. Due to the nature of his work, he was an exception to the Goldwater Rule to not use psychiatric expertise to comment on public figures. As I discussed in my eulogy of Dr Post on December 7, 2020, he spent many years working for our Central Intelligence Agency. Among many other useful profiles, that of Saddam Hussein was valuable for his country’s defeat and Hussein’s capture. If he was still alive, wouldn’t he be consulted about Putin?
Goodness knows. What could be more important for a country than national security?
There is so much more that needs psychiatric attention. Ross Douthat, in his column for the New York Times on March 18, 2023, “What It Means to Be Woke,” pointed out our deep and little recognized psychological structures that have inscribed themselves in our country’s very psyches from the intergenerational transmission of racist, homophobic, sexist, and heteronormative power.1 That chain of trauma reinforcement needs psychological recognition and intervention. Our country as a patient, if that can be imagined.
There also are psychiatrists who are dually trained in psychiatry and general medicine. Perhaps they would be the ideal options to cover both general health and mental health. I would not be surprised that someday, if our social psychiatric problems continue to escalate, that we could have a psychiatrist as US Surgeon General. Or if not, perhaps a new position as Assistant US Surgeon General or US Psychiatrist General!
As the saying goes, there is not only no health without mental health, but goodness knows, “good enough” health and mental health also need community and social health.
Dr Moffic is an award-winning psychiatrist who has specialized in the cultural and ethical aspects of psychiatry. A prolific writer and speaker, he received the one-time designation of Hero of Public Psychiatry from the Assembly of the American Psychiatric Association in 2002. He is an advocate for mental health issues related to climate instability, burnout, Islamophobia, and anti-Semitism for a better world. He serves on the Editorial Board of Psychiatric Times™.
1. Douthat R. What it means to be woke. The New York Times. March 18, 2023. Accessed March 23, 2023. https://www.nytimes.com/2023/03/18/opinion/woke-definition.html