A lifetime of service: A conversation with Kenneth Moritsugu, MD, MPH, FACPM, FAADE
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Diabetes has been a big part of both the professional and personal life of Kenneth Moritsugu, MD, MPH, FACPM, FAADE, retired Rear Admiral for the U.S. Public Health Service and former Surgeon General of the United States.
Moritsugu has held a number of roles connected to the field of diabetes, from vice president of global strategic affairs for diabetes at Johnson & Johnson after retiring from the U.S. Public Health Service to chairman of the board for the nonprofit organization Children with Diabetes. In 2013, Moritsugu joined the board of directors of what was then the American Association of Diabetes Educators, now the Association of Diabetes Care and Education Specialists, as the board’s first board-elected member. ADCES honored Moritsugu again in 2019 when he was named an honorary fellow by the organization.
Moritsugu’s understanding of diabetes goes beyond his career. He has lived with type 1 diabetes for more than 20 years, having been diagnosed with the disease at age 55.
“There is an emerging variant called latent autoimmune diabetes of adulthood, and I developed diabetes later in life,” Moritsugu said. “Throughout my career, I have always focused on putting the patient at the center of everything that we do. At the same time, I have been very much involved in diabetes, personally, as well as professionally.”
Moritsugu’s dedication to the field of diabetes had been recognized with yet another honor from ADCES. On Sunday at ADCES22, Moritsugu was presented with the organization’s Lifetime Achievement Award.
Healio recently spoke with Moritsugu about his long and distinguished career, what advice he has for young people interested in entering the field of medicine, and what the Lifetime Achievement Award means to him.
Healio: When did you decide you wanted to get into medicine and what attracted you to the field?
Moritsugu: My interest in medicine really started when I was a young child. My mother was a nurse receptionist at a primary care physician’s office. I spent a lot of time with her at the workplace. I also was exposed to a primary care physician before family medicine was in vogue. He was otherwise known as a general practitioner in the state of Hawaii and the community. I saw people who were suffering, and I was positively impressed by his ability to help them. Therefore, in my college years, I decided to focus in on medicine.
Healio: Is there a defining moment in your career that really stands out to you?
Moritsugu: I've been privileged to serve in many different capacities. I spent 37 years in the uniform of the United States Public Health Service and retired as the acting Surgeon General of the United States. That uniformed service career was followed by a civilian career in the private sector, where I was the vice president for Johnson & Johnson's diabetes medical device company. But during my overall career, I would look back on the opportunity I had when I was assigned to the department of justice, federal bureau of prisons where I was the assistant bureau director as well as the medical director. During that period, the position really encompassed oversight of the entire federal bureau of prisons system, not only in medicine and health care, but also in food services, nutrition and environmental health.
When I got to the federal bureau of prisons, the health care was adequate. But I was very concerned that the general public looked on people who worked in prison systems as the dregs of health professions, that they couldn't get a job anyplace else and that's the reason they wound up in the prison system. If anything, I found that that was exactly the opposite. You really had to be a complete health care professional and provider to be able to work within a health care system that balances public health with public safety.
To that end, early in my tenure, I said we're going to show the world what we are. I established a policy by which I said we are going to take every single one of our hospitals and our ambulatory care centers and we're going to get Joint Commission on Accreditation of Healthcare Organization (JCAHO) accreditation, which was a big gap, because at that time only our hospitals had been accredited.
About 3 or 4 years later, we were very proud to say 100% of the clinics and the hospitals in the federal bureau of prisons were accredited, and 30% of them were accredited with commendation, which is significantly greater than that in the population at large. So not only did we say that we provided care consistent with community standards, we proved it.
Healio: What was it like to serve as the acting Surgeon General of the United States?
Moritsugu: When I started in medical school at George Washington University, I was not really focused on what kind of a specialty I would move into. In my junior year, I was introduced to a course in public health and preventive medicine. I was very interested in not only helping individuals, but also broadening my perspective and helping communities and societies in public health. That's the reason I moved from clinical internal medicine to preventive medicine and have done a career in administrative medicine in public health.
incumbent is supposed to be apolitical and held to the standard of providing information consistent with the best science and evidence in ways that the general public can understand.
I was fortunate that I was selected as the deputy surgeon general and served in that position for 9 years, which I think is the longest serving deputy surgeon general the history of the U.S. Public Health Service. I was fortunate to be selected by David Satcher, MD, PhD the surgeon general in the early 1990s. Subsequent to him, there was an interregnum where I was the acting surgeon general between Satcher and his successor, Richard Carmona, MD, MPH. I was asked to remain as the deputy surgeon general with Carmona. At the end of his 4-year term, I then became again the acting Surgeon General, and I remained in that position for nearly 2 years until I decided it was time to retire and give others the opportunity to fill those positions.
Healio: What advice would you offer a student interested in health care today?
Moritsugu: The first thing that I would offer to a student who is considering health and health care as a profession is to go back to the ancient Greek saying, “To thine own self be true.” Understand truthfully what your own motivation is. Is it to serve? Is it to help? Is it ego? Is it economics? Any purpose is a valid purpose as long as you can fully appreciate and understand that that's where you're coming from.
Then the question is which pathway is the best for you to achieve what you want to achieve with what you have at the time. The decision that you make today when you are bringing home $5,000 a year by washing cars is going to be a heck of a lot different than if you are 30 years into a neurosurgical practice where you are bringing home a few additional zeros before the decimal point.
In addition to that, do you appreciate the ego satisfaction of being addressed as doctor, or are you more inclined to say, “I’m here to help, not necessarily to be addressed as doctor?” It gets back again to my original comment, to thine own self be true, because the worst thing that could happen is, if you really are interested in functioning in a certain way, but you say, I’m going to overreach and earn the medical degree, you may be unhappy from a service perspective, from an ego perspective and from a financial perspective.
I speak to a number of students from time to time, and I say if you really are interested in serving people, how much time and effort and how much money are you willing to invest in achieving that? If time is of your essence, why are you interested in putting in 4 years of a medical school career and 3 years of a residency program before you will even begin to touch a patient as an independent care provider, as opposed to earning a master's degree and functioning as a physician assistant? Or graduating with a 4-year bachelor of science in nursing, taking 2 years to get a master’s degree in nursing and perhaps being a nurse practitioner and being able to then engage in service?
Healio: What was your reaction when you learned you would be the recipient of the Lifetime Achievement Award from ADCES?
Moritsugu: It means everything to me. As has been said by others, there is no better acknowledgement then to be acknowledged by your peers.
All along my path, there has been a way that I’ve felt I could serve, and I could help people, and I could help patients. From that perspective, expect nothing and you will never ever be disappointed. When I got the call from the president of ADCES saying, “Ken, we would like to have you receive and accept the Lifetime Achievement Award,” I can tell you I was elated, I was humbled, and I was very proud as well. Everything is a balance of perceptions and responses and realizing that service does have its rewards.
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