March 10, 1981
Dear Mr. Waxman:
It is our understanding that in order to appoint Dr. C. Everett Koop as Surgeon General, U. S. Public Health Service, a statutory change must be authorized by your Subcommittee.  We wish to call your attention to the fact that APHA has gone on record in opposition to this nomination. While it is appropriate that the Surgeon General of the Public Health Service should be a physician, it is critical that the Surgeon General be a physician trained and experienced in public and community health rather than solely in clinical medicine.  There is no single profession except the profession of public health itself which covers the full spectrum of public health.  The professional skills of physicians, biologists, chemists, physicists, planners, nurses, environmental scientists, environmental engineers, bacteriologists, virologists, and scores of others have a contribution to make to the field, but no one of these encompasses the total spectrum of public health practice.  Those trained and experienced solely in clinical medicine deal with the treatment of patients, typically on a one-to-one basis. Public health professionals however deal with populations and communities with a primary emphasis on prevention. The two activities, treatment and prevention, are extremely dissimilar in approach and practice.
Many recent improvements in the health status of Americans have been due primarily to prevention activities and changes in lifestyles.  Future improvements in health status and the quality of life must and will emanate primarily from improvements in disease prevention, health promotion, and improved control of environmental contaminants and pollution.  Secretary of the Department of Health and Human Services, Richard S. Schweiker has consistently identified the need for an increased emphasis on prevention.  This theme prevailed in the Republican Platform as well.  Thus, the need to have a Surgeon General trained and experienced in public health rather than in clinical medicine and medical research has never been more important.
We are confident that a qualified senior official from the U. S. Public Health Service, whose views are compatible with those of the Administration,  and who has the training and experience necessary to be sensitive to the needs of public health can be identified, nominated and confirmed.  The best interests of the health of our citizens will be served by the appointment of a public health professional who has the skills and desire to further the causes of disease prevention, health promotion, and environmental health.
Thank you for your consideration of our views.
Very truly yours,
Larry J. Gordon, M.S., M.P.H.
President