July 13, 2009 ( UPDATED ) — President Barack Obama announced today that he would nominate Regina Benjamin, MD, a family physician in the fishing village of Bayou La Batre, Alabama, to be the next US surgeon general. The appointment requires confirmation by the US Senate.

In one sense, the former community organizer in Chicago turned US senator and then US president chose someone very much in his mold. Dr. Benjamin's service in the poor Gulf Coast community of 2500 — devastated by Hurricane Katrina in 2005 and Hurricane Georges in 1998 — has been a springboard to medical leadership on a national scale. Dr. Benjamin has served on the board of trustees of the American Medical Association (AMA), for example. And she's the immediate past chair of the Federation of State Medical Boards of the United States.

Appearing with President Obama when he announced the nomination, Dr. Benjamin said she wanted to ensure "that no one — no one — falls through the cracks as we improve our healthcare system." Fueling her motivation, she explained, was the medical history of her own family.

"My father died with diabetes and hypertension," said Dr. Benjamin. "My older brother, and only sibling, died at age 44 of HIV-related illness. My mother died of lung cancer, because as a young girl, she wanted to smoke just like her twin brother could. My Uncle Buddy, my mother's twin, who's one of the few surviving black World War II prisoners of war, is at home right now, on oxygen, struggling for each breath because of the years of smoking."

Voice for Improved Healthcare

"My family is not here with me today, at least not in person, because of preventable diseases. While...I cannot change my family's past, I can be a voice in the movement to improve our nation's healthcare and our nation's health for the future."

In 1990, Dr. Benjamin founded the Bayou La Batre Rural Health Clinic, which she has had to rebuild 3 times because of the 2 hurricanes as well as a fire. Patients have pitched in money to help the nonprofit clinic recover, but Dr. Benjamin received an even bigger boost in 2008, when the John T. and Catherine D. MacArthur Foundation awarded her a $500,000 "genius grant," one of numerous honors she has received.

Many Bayou La Batre residents — a third of whom are immigrants from Vietnam, Cambodia, and Laos — lack health insurance. Doctoring in such a community makes her well-qualified for the post of surgeon general, said Georges Benjamin, MD, executive director of the American Public Health Association (no relation to Dr. Regina Benjamin).

"She has Ivy League credentials, but she's not coming from an Ivy League practice," said the American Public Health Association's Dr. Benjamin, who has worked with her on health policy issues over the years. "She brings the experience of someone who's actually had to manage a person's blood pressure, and deal with people who can't afford healthcare."

"True Understanding"

Ted Epperly, MD, president of the American Academy of Family Physicians, also applauded her nomination, saying that Dr. Benjamin understands the need for both universal healthcare coverage and enough primary care physicians to deliver the care.

"She has a true understanding of what it means to care for the underserved and address healthcare disparities," said Dr. Epperly. "She's very caring and empathetic, but tough. She won't give up. Look how many times she rebuilt her clinic. You've got to love that grit."

Dr. Georges Benjamin said the nominee for the highest physician post in the land also comes well prepared to deal with the political challenges of the job, which will heat up as President Obama and Congress attempt to forge a path toward healthcare reform. "There's no more a political environment than the board of trustees of the AMA," noted Dr. Georges Benjamin. "She understands bureaucracies and the political environment. She's dealt with state legislators in Alabama. She's presented for the AMA on Capitol Hill. She's no rookie."

Personal Understanding of Pitfalls

Although Dr. Benjamin's nomination has received much praise, some online news sites have posted comments from readers who are dismayed that the surgeon general nominee is overweight. "An overweight surgeon general will not have the credibility to deal with the nation's most serious health problem, obesity," wrote one reader at the New York Times Web site.

Dr. Epperly of the American Academy of Family Physicians, however, defended Dr. Benjamin's right to occupy the bully pulpit on this subject. "She more than anybody understands what it means to be overweight and for that to be a health issue," said Dr. Epperly. "She will help champion [this cause] even harder."

Her situation, he added, "isn't dissimilar to President Obama being a smoker and signing the [US Food and Drug Administration] legislation" that authorizes the Food and Drug Administration to regulate tobacco. "As a smoker, he understands the pitfalls of smoking and addiction," said Dr. Epperly. "I think she understands the pitfalls of the obesity epidemic."

Dr. Benjamin received her MD from the University of Alabama at Birmingham. She also holds an MBA from Tulane University.