Still paging Dr. Gupta? What's the holdup?

WASHINGTON, D.C.; February 23, 2009

But what is taking so long for the message to go through, and has the celebrity doctor answered the call?

Despite some concerns about Gupta's qualifications, the reason the surgeon general selection has not been formally announced since Gupta's name leaked on Jan. 6 may have nothing to do with Gupta himself.

One month into the Obama presidency, there are still several high-level positions empty in the new president's administration -- including a spot for the incoming secretary of Health and Human Services. HHS is the umbrella agency that encompasses the office of the surgeon general.

Given the Feb. 3 withdrawal of Tom Daschle, Obama's initial pick for the HHS secretary's post, several medical experts said Obama's team may now be reassessing the balance.

"Whether or not a new HHS secretary would want him or how this works out, I think this is all up in the air," ABC News medical contributor Dr. Timothy Johnson told ABCNews.com Thursday.

The White House, too, said it is waiting to fill the top post at HHS before making an announcement. Coupled with efforts to make the vetting process more stringent after the withdrawal of three Cabinet nominees, the Obama team may take its sweet time in bringing Gupta to Washington.

Of course, it's possible that logistical and financial concerns, as well as hiccups in the vetting process, could be playing a part, too.

For starters, Gupta would likely take a pay cut as he moves from television personality and neurosurgeon to federal employee. As CNN's chief medical correspondent, a practicing neurosurgeon and associate chief of neurosurgery at Grady Memorial Hospital in Atlanta, and an assistant professor of neurosurgery at the Emory University School of Medicine, Gupta likely earns much more than he would as surgeon general.

Meanwhile, the prospect of Gupta taking the job has also proven controversial.

Dr. James Floyd, researcher at consumer advocacy group Public Citizen, said several of Gupta's broadcast reports "undermine his credibility," whether reporting on autism or screening tests and prevention.

For instance, Floyd is among those who said Gupta was too soft on Merck's Vioxx drug before it was removed from the market, explaining, "He completely just misinterpreted how the data was reported."

"He seems a lot of times like a spokesperson for the latest and greatest drugs or technology," Floyd said.

Gupta also found himself at the center of a very public flap about getting his facts wrong in critiquing filmmaker Michael Moore's documentary "Sicko," which was about America's health care problems. The filmmaker and the doctor hashed it out on "Larry King Live."

"Whatever you think about the movie or Michael Moore, [Gupta] really just did it wrong," Floyd said.

According to the office's Web site, the surgeon general's mission is to serve "as America's chief health educator by providing Americans the best scientific information available on how to improve their health and reduce the risk of illness and injury."

Meanwhile, Gupta continues to report for CNN, though the media outlet has vowed to ensure he does not cross the line now that he is a potential political nominee.

"Since first learning that Dr. Gupta was under consideration for the U.S. surgeon general position, CNN has made sure that his on-air reporting has been on health and wellness matters and not on health care policy or any matters involving the new administration," the network said in a statement released last month.

"If he just sticks to clinical matters, I think that's OK," Johnson said.

Still, Gupta's star power could be an asset for Obama's administration in helping to raise the profile of the office and sell health decisions to the public.

"I think that when he was initially announced, a lot of people touted that he's a prominent public figure and he has a large TV audience, so the capacity of the surgeon general to disseminate a message, he could fill that role well," Floyd said.

Among those who consider him a good fit for the job is former surgeon general Jocelyn Elders, arguably the most controversial person to hold the post. Elders resigned in 1994 after making a controverisal statement about masturbation.

In addition to his current jobs, Gupta, 39, was chosen for the selective White House Fellows program in 1997, through which he served as special advisor to Hillary Clinton when she was first lady.

Still, others outside of the medical community have said they'd oppose his appointment.

"There are highly experienced medical professionals who question whether Dr. Gupta has the necessary experience or even the medical background to be in charge of the 6,000 physicians who work in the United States Public Health Service," wrote Rep. John Conyers, Jr., a Democrat from Gupta's home state of Michigan, in a letter to House lawmakers opposing the pick.

Conyers later added, "Clearly, it is not in the best interests of the nation to have someone like this who lacks the requisite experience needed to oversee the federal agency that provides crucial health care assistance to some of the poorest and most underserved communities in America."

Meanwhile, Karen Davis, president of The Commonwealth Foundation, a private foundation that supports research on health system performance, said the timing of Obama's picks is nothing unusual.

"In general, it's hard to get all those appointments in place and vetted," said Davis, who served as a health official under President Carter.

Still, she added, "Health is an urgent issue that needs attention, so the sooner they have leadership, the better."

Others said the holes in Obama's team could be particularly glaring when it comes to health care.

"I think it's a huge problem," Johnson said Thursday, calling the Department of Health and Human Services "rudderless" without a secretary to lead the agency.

Though Kansas Gov. Kathleen Sebelius remains the leading contender for the position, the administration would subsequently need to fill the other open positions under HHS' purview, including a leader for the beleaguered Food and Drug Administration and a director for the Centers for Disease Control and Prevention, as well as a surgeon general.

Also uncertain is the fate of the newly created Office of Health Care Reform, an arm of the White House that Obama announced when declaring Daschle his nominee.

Still, Davis said she is pleased by the health strides the new administration has made in a short period of time -- including enacting a law expanding kids' health care and allocating money for health issues, such as prevention and wellness programs in the economic stimulus package.

"Even without a secretary in place, certainly major things are happening," Davis said.

"It's hard to make the case that you can't move forward in a significant way on health care without a secretary in place because this is more action in the first months of a new president than I think we've seen in a long time," she added.

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