Family physician and U.S. Surgeon General Regina Benjamin, M.D., M.B.A., found a sympathetic audience among her colleagues during her keynote address at the opening ceremony of the 2010 AAFP Scientific Assembly here on Sept. 29. Benjamin drew laughter and applause as she discussed changes in the U.S. health care system, health care disparities and childhood obesity.
Benjamin, an AAFP member since 1987, related that she got started in organized medicine by advocating for inclusion of education about STDs in medical schools. "I learned that one person can make a difference whether it is in medical policy or medical practice," said Benjamin, sparking applause from her audience.
Before becoming surgeon general, Benjamin spent more than 20 years as the founder and CEO of Bayou La Batre Rural Health Clinic on Alabama's Gulf Coast where she took care of more than 2,000 of Alabama's working poor. Like other family physicians, Benjamin quickly learned that her patients had problems that her prescription pad alone could not solve -- problems such as inadequate housing, scarce employment opportunities and the unavailability of clean water.
"I had to deal with the land sharks, the regulators, the reviewers, the red tape dispensers and (people) I jokingly call the hammerheads -- the lawyers," she said, as the audience laughed along with her.
Her patient base made Benjamin acutely aware of the disparities in health care that exist in the United States, so she said she is particularly pleased that the Patient Protection and Affordable Care Act requires insurance companies to cover preventive services and to not require a copay or a deductible for these services.
As surgeon general, Benjamin said she spends a lot of time "trying to bring clarity and understanding to the overwhelmingly confusing conversation about health and health care."
"I am especially grateful to serve at this historic time as we make overdue changes in how we finance and deliver health care -- changes that will eventually give all Americans access to the high-quality affordable health care that they deserve," she said, as the audience broke into sustained applause.
However, giving all Americans health care coverage is only the first step in reducing the health disparities that plague our country, said Benjamin. "We know that reducing and, ultimately, eliminating health disparities will require more than just giving Americans an insurance card. We have to address the social determinants of health, such as poverty."
The second step in reducing disparities is prevention, said Benjamin. "Prevention is the foundation of our nation's public health system. And prevention is the foundation of my work as surgeon general."
Benjamin referred to the first report she issued as surgeon general last January. "The Surgeon General's Vision for a Healthy and Fit Nation"(www.surgeongeneral.gov) highlights the growing number of overweight and obese Americans and outlines the causes and health consequences of obesity.
"There are perhaps no more serious challenges to the nation's health and well-being than those posed by obesity and overweight," said Benjamin. "Since 1980, obesity rates have doubled in adults and tripled in children. And the problem is even worse among black, Hispanic and Native American children."
More than two-thirds of adults and more than one in three children are overweight or obese, said Benjamin, which has led to higher rates of chronic diseases, such as diabetes, heart disease and other chronic illnesses that are starting to affect children in the United States.
"My Vision for a Healthy and Fit Nation is an attempt to change the national conversation from a negative one about obesity and illness to a positive conversation about being fit and healthy," said Benjamin, as she noted that she has been trying to set a good example this summer by doing surgeon general walks around the nation.
"Just about 10 days ago, I actually saw for the first time and hiked the Grand Canyon from rim to rim," said Benjamin. "It meant the first day I went 14 miles straight down -- 5,000 feet -- and the next morning I went back up," she said, sparking laughter and applause from the audience. "The point is that I'm not an athlete or a big fitness guru, but if I can do it, anybody can, and all you have to do is walk," said Benjamin to thunderous applause.
"There needs to be a connection between the clinicians, fitness professionals and the public, so that everyone can receive the guidance they need to stay healthy and active. I believe that exercise is the new medicine, but we need to have fun doing it, you need to have a good time -- dance, play -- enjoy being healthy and fit, no matter what size you are," Benjamin said.
"This really is an exciting time to be in health care," said Benjamin. "We have an opportunity to make our health system work better for our patients and for our doctors." But at the same time, she added, as "a family doctor and as America's doctor, I cannot stand here without saying to you, 'You need to take care of yourself.'"
"As doctors, we take care of everyone else, and we put ourselves last," said Benjamin. "We have to play, exercise, enjoy, have fun, and vacation."
But she also pointedly reminded members that flu season is beginning. "Make sure you take your own flu shot," she gently chided them, generating laughter from the audience of physicians.