History of the Office of the Surgeon General

In 1798, Congress established the U. S. Marine Hospital Service—predecessor of today's U.S. Public Health Service—to provide health care to sick and injured merchant seamen. In 1870, the Marine Hospital Service was reorganized as a national hospital system with centralized administration under a medical officer, the Supervising Surgeon, who was later given the title of Surgeon General.

Dr. John Woodworth, was appointed as the first Supervising Surgeon in 1871, and established a cadre of medical personnel to administer the Marine Hospital System. On January 4, 1889, the Congress recognized this new personnel system by formally authorizing the Commissioned Corps (Corps). The Corps was established along military lines to be a mobile force of professionals subject to reassignment to meet the needs of the Service. Originally, the Corps was composed only of physicians. However, over the years, as the functional responsibilities of the Public Health Service (U.S. PHS) and the Corps have broadened, a commensurate broad range of health professionals has been included.

Prior to 1968, the Surgeon General was the head of the PHS, and all program, administrative, and financial management authorities flowed through the Surgeon General, who reported directly to the Secretary of Health, Education, and Welfare. In 1968, pursuant to a reorganization plan issued by President Lyndon B. Johnson, the Secretary delegated line responsibility for the PHS to the Assistant Secretary for Health. The Office of the Surgeon General was abolished and the position of Surgeon General became that of a principal deputy to the Assistant Secretary for Health (ASH) with responsibility for advising and assisting on professional medical matters. In addition, a primary role developed in which the Surgeon General became the PHS spokesperson on certain health issues. (Note: In 1972, the Surgeon General again became an advisor to the Secretary rather than the ASH. In 1977, the positions of ASH and Surgeon General were combined; in 1981, they were separated again.)

In 1987, the Office of the Surgeon General (OSG) was reestablished as a staff office within the Office of the Assistant Secretary for Health. Concomitant with this action, the Surgeon General again became responsible for management of the Commissioned Corps personnel system. (Note: The Surgeon General does not directly supervise all Commissioned Officers; most work in PHS or other agencies and report to line managers of those agencies who may or may not be in the Corps.) In carrying out all responsibilities, the Surgeon General reports to the Assistant Secretary for Health, who is the principal advisor to the Secretary on public health and scientific issues.

In April 1987, Surgeon General C. Everett Koop launched a major effort to revitalize the Corps. Actions were taken to enhance all aspects of Corps management, including recruitment, especially of women and minorities, assignment, career development, and communication. Special efforts were made to make sure that agencies utilizing officers are actively involved in the formulation and review of policies and procedures related to administration of the Corps.

There currently are more than 6,500 officers on active duty. Officers are assigned to all HHS Agencies and to a number of agencies outside of HHS, including the District of Columbia Commission on Mental Health Services,  Environmental Protection Agency, Federal Bureau of Prisons, National Oceanic and Atmospheric Administration, National Park Service, U.S. Department of Agriculture, U.S. Department of Defense, U.S. Department of Homeland Security, and the U.S. Marshals Service.