A group photo from Invisible Corps presentation at UCSF

Founded more than 200 years ago, the USPHS is a uniformed cohort of about 6,000 specialists of all kinds – including doctors, nurses, pharmacists, dentists, researchers, basic scientists, therapists, engineers, environmentalists, and technical experts – that operates primarily behind the scenes and can be deployed to the front lines of public health crises around the world. Despite being under the radar of many Americans, the USPHS has played, and continues to play, a crucial role in national and global public health since the beginning of our nation.

For a better understanding of the Commissioned Corps’ work, watch the recent PBS documentary, Invisible Corps. Among other luminaries, the film features two extraordinarily talented UCSF alumni who enjoyed top leadership roles in the USPHS: Richard Carmona, MD ’80, MPH, 17th US Surgeon General, and Pam Schweitzer, PharmD ’87, the nation’s first female chief pharmacy officer in 2014 and assistant US Surgeon General.

US Public Health Service

Calls to action include:

  • Tobacco and secondhand smoke
  • 9/11
  • Iraq War
  • Hurricane Katrina
  • 2004 Indian Ocean tsunami
  • Ebola crisis
  • Swine flu
  • Wildfires
  • Affordable Care Act implementation
  • COVID-19 pandemic

Joining the Service

People have numerous reasons for joining the USPHS. As a trauma surgeon, Carmona knew he could sometimes fix people, but he felt that fixing them once they were already broken wasn’t good enough. He wanted to get to people before they needed fixing and to support policies that created better health for populations and prevented disease, trauma, and violence.

“After several years of being a surgeon, I realized what I was actually doing was being a repairer of society’s indiscretions. When somebody killed someone with a gun that we allowed them to buy, or a drunk driver maimed an innocent person, or a victim of domestic violence needed medical help, it felt disingenuous to ignore the fact that many of these events were preventable.”

Schweitzer entered the USPHS initially because of her desire to serve and her husband’s love of adventure. “We were outdoorsy and willing to take a chance,” she said. Her first posting was to South Dakota (she’d never been farther than Arizona but took the job sight unseen) on an Indian reservation. It was during this time that she consolidated some of her foundational leadership skills.

Learning Crucial Leadership Skills

“I learned how to observe, listen, and lead from behind,” she said. “This is how it is when the USPHS goes any place in the world. It is us listening to the community we are trying to help, not us coming in and saying we know how to do this better than you.”

Carmona’s leadership skills began at an early age. When he was 12, his mother entrusted him with taking care of his three younger siblings while she worked the night shift.

“I knew my brothers’ and sisters’ destinies were in my hands and that everything I did and said affected them,” he recalled. “At that time, my world was small, but my mother’s values were big and have stuck. No matter where I was in the arc of leadership, the values she taught me remained.”

As US Surgeon General from 2002 to 2006, Carmona was called upon to lead in numerous challenging situations. His troops were deployed after 9/11, during the Iraq War, following the Boxing Day 2004 tsunami in the Indian Ocean, and in the wake of Hurricane Katrina in 2005. Even though Carmona is officially retired as Surgeon General, he’s a Distinguished Laureate Professor, was the COVID-19 incident commander for the University of Arizona, and also helped Arizona Gov. Doug Ducey create a COVID-19 plan for the state. The USPHS played a pivotal role in establishing some of Arizona’s COVID policy and its first vaccination stations, which became models for similar facilities around the country.

As Schweitzer climbed the career ladder in the USPHS, she found her way into health policy. In the Indian Health Service, she provided support to tribes that wanted to take over control of eligible federal government programs.

“I was determined to work myself out of a job,” Schweitzer said. “The tribes needed us to listen, understand, and support as they learned to manage health care for their own community.”

Straddling Politics and Moving Forward

As in all of the United States Uniformed Services, the positions in the USPHS are government appointed. Leaders like Carmona and Schweitzer often find themselves challenged by partisan politics when the best science clashes with political agendas. When Schweitzer worked for the Center for Medicare and Medicaid Service, she helped states modernize their Medicaid eligibility and enrollment systems and drug pricing. During the implementation of the Affordable Care Act, she supported states as they put the new legislation into effect.

“Change is difficult; it can be challenging,” she said.

“We have troops all over the world. Leadership is demanding in a democracy, since the ultimate authority rests with those we elect,” said Carmona. It’s something he sometimes struggled with but came to accept as part of the role. “It can be frustrating,” he admitted, “but you have to tolerate that frustration if you want to serve at the highest levels, and you have to be cognizant that everything you say and do reflects back on the organization and its brand.” At times the most important thing you can do is to contest politicians with inconvenient scientific truths.

Before joining the USPHS, Carmona, a high school dropout, enlisted in the Army at 17 years old and joined the United States Army Special Forces. He became a combat decorated Vietnam veteran, where he received some of the top military accolades, including two Bronze Stars and two Purple Hearts. He also is a highly awarded police officer.

“In every iteration of my leadership roles, I’ve learned how to be a better leader,” he said.

The Impact of UCSF

Both Schweitzer and Carmona laud UCSF faculty mentors for teaching them the value of public health, the importance of diversity, and the responsibilities of a health care leader. Before she was dean of the School of Pharmacy, Mary Anne Koda-Kimble, PharmD, was one of Schweitzer’s professors and advised her to think about balancing family and career. How were she and the other women pharmacy students going to manage it? That wasn’t something that had occurred to Schweitzer.

When she became chief pharmacist of the Commissioned Corps of the USPHS, everyone wanted to be Schweitzer’s “best friend.” She turned to Koda-Kimble again to seek advice on how to best work with the pharmacy profession, numerous pharmacy organizations, and schools. Koda-Kimble suggested Schweitzer form a group of trusted individuals who felt comfortable questioning her judgment and would help her see issues more clearly.

“I am so grateful to the faculty members who were there at the time I was doing my pharmacy degree and continued being there for me. They are, and were, the best of the best,” Schweitzer said.

“Pam and I were able to take a lot of the skills we learned at UCSF to a bigger stage, and the education we received here made us more powerful advocates for equality and social justice,” Carmona added.

Experience the film to learn more