While Murthy's office is independent, he has to pick his fights carefully. | AP Photo Pulse Check: The surgeon general isn’t scared to speak out on guns

As a doctor who worked at one of Boston's busiest hospitals, Vivek Murthy is no stranger to life-and-death situations. But it's still a minor political miracle that he survived a battle with the NRA — a yearlong standoff over Murthy's comments about gun violence had threatened to derail his nomination for surgeon general before he was eventually confirmed in 2014.

The bruising confirmation fight has made Murthy wary of misspeaking, but two years into the job, it hasn't changed his mind on guns.


"What I’ve said before is what I believe now — which is gun violence is a public health issue," Murthy told POLITICO's "Pulse Check" podcast. "I won’t shy away from saying that. It makes some people nervous when I say that. Frankly, I don’t care because the truth is the truth."

But for all the political fighting over his nomination, Murthy has hardly made gun violence a focus in the job.

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"I wouldn’t say that I’ve avoided it," he said. "What’s interesting to me is I had a series of issues I wanted to focus on and gun violence was an important issue I wanted to speak upon. But my highest priority coming into the office [was] our epidemic of chronic disease in America that’s killing more people than anything else and costing us in terms of health care dollars."

As surgeon general, Murthy doesn't have the same direct control over federal resources as other senior HHS appointees, who run agencies like CMS or FDA. But his public profile is almost certainly higher, thanks to the decades of prominent predecessors like C. Everett Koop, who broke with Ronald Reagan's administration to highlight HIV/AIDS.

While Murthy's office is independent, he has to pick his fights carefully; the Clinton administration in 1994 forced then-Surgeon General Joycelyn Elders to resign after her comments on abortion, drugs and sexuality sparked conservative opposition.

Some critics say that, in 2016, the nation doesn't even need a surgeon general, given the myriad ways of informing the public. And while HHS calls Murthy "America's Doctor," he has competition — TV show host Dr. Oz, whose endorsement of dubious medical treatments has upset many in the medical field, has actually trademarked the term.

Murthy argues that it's essential to have a recognized authority who can articulate the nation's health priorities. He also sees his job as a kind of translator.

"To me … this is about setting this office up for the future — for the next surgeon general," he added. "So that there is a modern platform [to] bring much-needed health information to the public and also so that the public can feel a connection to the office."

The youngest surgeon general ever and a former entrepreneur, Murthy said that he admires predecessors like Luther Terry, who broke new ground in the 1960s by issuing warnings on tobacco.

Murthy's breaking new ground of his own. He's pushed the surgeon general's office into the social media age, participating in viral videos with Elmo of "Sesame Street" and NBA star Stephen Curry to increase vaccination rates and get kids exercising. He's also seized on the growing wearables movement. Last month, Murthy partnered with Fitbit on a national walking challenge, with participants logging more than 60 billion steps.

Murthy's also kept his focus on one of America's most pressing health problems: the opioid epidemic.

For instance, Murthy sent a letter this summer to 2.3 million clinicians, urging them to take part in efforts to curb opioid over-prescriptions — the first time in the office's long history that the surgeon general has directly called on the medical profession to act on a specific public health issue. The first-ever surgeon general's report on substance abuse and addiction will be released Nov. 17.

Murthy said that fighting addiction will remain a focus of his career, presumably after he leaves office. "It’s absolutely critical," Murthy said. "And [a fight] I want to remain involved in for a very long time."

Murthy also teased one of his top priorities for 2017: improving Americans' emotional well-being. It gets less attention than addressing physical well-being, he acknowledges, but he said there's a clear link with improving health and educational outcomes and even workplace productivity.

"We underestimate the impact it has on our health," Murthy said. "Social isolation is linked to shorter lives, cognitive decline and increased rates of cardiovascular disease as well as other health care concerns."

Another change for next year: Murthy will be getting a new boss. His four-year term doesn't expire until 2019, which means it's possible he serves out two years under Donald Trump's administration. And while Trump has taken public health stances that don't appear to completely square with Murthy's own — for instance, Trump's approach to combating illegal drug use focuses more on crime — Murthy said he's optimistic he'll find common ground with the next president, whoever he or she is.

"The bottom line is that there is broad interest across political parties and demographics to address [the opioid] epidemic," Murthy said. "That’s why I intend to make it a priority in the next administration."

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