The Surgeon General of the United States is the head of the United States Public Health Service Commissioned Corps (PHSCC) and thus the leading spokesperson on matters of public health in the Federal government of the United States.
The Surgeon General is nominated by the President of the United States and confirmed via majority vote by the United States Senate. The Surgeon General serves a four year term of office and is commissioned as a Vice Admiral in the PHSCC. In carrying out all responsibilities, the Surgeon General reports to the United States Assistant Secretary for Health, who is the principal advisor to the United States Secretary of Health and Human Services on public health and scientific issues, and is the overall head of the United States Public Health Service (PHS).
The former Surgeon General, Vice Admiral Richard Carmona, appointed by President George W. Bush in 2002, left office when his term expired on July 31, 2006. Rear Admiral Kenneth P. Moritsugu is functioning as the Acting Surgeon General.
On May 24, 2007, President Bush nominated James W. Holsinger, a University of Kentucky medical professor to be the 18th Surgeon General of the United States.
The Surgeon General functions under the direction of the Assistant Secretary for Health and operationally heads the 6,000-member Commissioned Corps of the USPHS, a cadre of health professionals who are on call 24 hours a day, and can be dispatched by the Secretary of HHS or the Assistant Secretary for Health in the event of a public [health emergency. The Surgeon General is also the ultimate award authority for several public health awards and decorations, the highest of which that can be directly awarded is the Surgeon General's Medal (the highest award bestowed by board action is the Distinguished Service Medal (United States)|Distinguished Service Medal).
The Surgeon General also has many informal duties, such as educating the American public about health issues and advocating healthy lifestyle choices.
The office also periodically issues health warnings. Perhaps the best known example of this is the Tobacco packaging warning messages#United States of America|Surgeon General's Warning labels that can be found on all packages of American cigarettes. A health warning also appears on alcoholic beverages.
Past American Surgeons General have often been characterized by their outspoken personalities and often controversial proposals on how to reform the U.S. health system. Because the office is not a particularly powerful one, and has little direct impact on policy-making, Surgeons General are often vocal advocates of unconventional, unusual, or even unpopular health policies. Vice Admiral C. Everett Koop and Vice Admiral Joycelyn Elders were two former Surgeons General who were well known for their controversial ideas, especially on sex education.
The U.S. Public Health Service was under the direction of the Office of the Surgeon General and was an independent government agency until 1953 at which point it was integrated into the United States Department of Health, Education, and Welfare, and later into the United States Department of Health and Human Services. Although the U.S. Public Health Service and the Surgeon General were at various times under the umbrella of the Department of the Treasury or the Federal Security Agency, the agency operated with a substantial amount of independence.
The Surgeon General is a commissioned officer in the Public Health Service Commissioned Corps, one of the seven uniformed services of the United States, and by law holds the rank of Vice Admiral. Officers of the PHSCC and the National Oceanic and Atmospheric Administration Commissioned Corps (NOAA Corps) are classified as non-combatants, but can be subjected to the Uniform Code of Military Justice (UCMJ) and the Geneva Conventions when designated by the Commander-in-Chief as a military force. Officer members of these services wear uniforms that are similar to those worn by the U.S. Navy, except that the commissioning devices, buttons, and insignia are unique. Officers in PHS and NOAA wear unique devices which are similar to U.S. Navy Staffing Corps Officers (e.g., Medical Services Corps, Supply Corps, etc).