The role is something of a figurehead, but can be wielded as a bully pulpit, too—and that is something that concerns his critics: Murthy’s greatest professional accomplishment to date is being an excellent physician organizer.

Two years out of residency, Murthy flashed his political colors. He co-chaired the advocacy group Doctors for Obama during the 2008 presidential campaign. Shortly after the inauguration in 2009, this body of 16,000 physicians changed its moniker to Doctors for America, an organization with the stated goal of improving health-care access.

For this, Murthy is facing opposition from conservative groups. No recent surgeon general nominee has had such a record of activism. In an election year when the shortcomings of Obamacare have become a major flashpoint, Republicans fear Murthy could use the Office of Surgeon General to become a secondary mouthpiece for the virtues of the new health-care law. Both President Obama and Secretary of Health and Human Services Kathleen Sebelius would likely benefit from a fresher voice supporting their efforts on this topic.