Senator Edward Kennedy
Senate Health, Education, Labor and Pensions Committee
Dear Chairman Kennedy,
I am writing to strongly urge you and your committee to vote against the confirmation of Dr. Richard Carmona as Surgeon General at the hearing you will be chairing on his nomination tomorrow. According to a lengthy investigative article in today’s Los Angeles Times, there are serious questions about his integrity that, in my view, disqualify him for the important office of Surgeon General.
Retired University of Arizona surgeon Dr. Charles Putnam, who has worked with Carmona said, in a letter he sent you several months ago, that he opposed Carmona as Surgeon General because he “was removed from his two previous administrative appointments [in Tucson]…. because he could not work in an effective or even a civil manner with health professionals and other constituencies of those positions.”
Based on other information in the article, there are also very serious questions about his integrity. When he applied to take the Board examination in Emergency Medicine, he said in a sworn statement that he had worked 5,000 hours as an emergency room physician, thereby apparently filling the training requirement necessary for him to take the Board examination. When the American Board of Emergency Medicine sought to verify this with the medical director of emergency services at the hospital where Carmona had worked, Dr. Keith Kaback, it was told that “Carmona had worked virtually no hours as an emergency physician.” The Board’s guidelines properly require those seeking certification as emergency room physicians to have worked on the diagnosis and treatment of the extraordinary variety of patients who come into emergency rooms and that being called there for special cases, such as performing trauma surgery, do not count towards the requirement.
Dr. Carmona, who had been physically present in the emergency room doing emergency trauma surgery, rather than diagnosing and treating the whole scope of cases which present to the emergency room, nevertheless attempted to get credit for hours present in the emergency room even though they were not spent learning the variety of skills necessary to become board-certified. When the Board learned of this, they rejected his application.
This and other questions about his character and integrity detailed in the Los Angeles Times article should cause the rejection of his nomination if the importance of the mission of the Surgeon General is to be maintained. From the beginning of this important position through the last Surgeon General, Dr. David Satcher, the holders of this office have been people of unquestioned integrity as Surgeons General and have properly used this public trust to educate people in this country about urgent public health issues such as smoking, AIDS, violence, diet, mental illness and many other issues. The common denominator and prerequisite for having public trust is unquestionable integrity. Knowing what is already known about Dr. Carmona raises so many questions about his integrity that when more people become aware of this, as they inevitably will, it will be difficult if not impossible for many people to believe the pronouncements he makes as Surgeon General. The field of public health has too many other physicians whose character and integrity have not been questioned and who have a much more extensive public health background than Dr. Carmona to make the serious mistake of confirming him. Although several physicians I know in Tucson have described him as a “charismatic cowboy,” and I have no reason to doubt either attribute, these qualities are hardly sufficient to overcome the other problems concerning Dr. Carmona.
I am willing to speak with you about this important decision if that would be helpful.
Sidney M. Wolfe, M.D.
Public Citizen’s Health Research Group