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Big challenge for new state surgeon general

TALLAHASSEE — The state's new surgeon general says he has no delusions about the tough job before him.

Dr. John Armstrong leads an agency in transition, some even say turmoil. The Department of Health is in the middle of a massive reorganization and downsizing, and some public health advocates have criticized the changes. A long list of top department officials have resigned or been forced out.

Armstrong, hired away from the University of South Florida, is the second surgeon general since Gov. Rick Scott took office 18 months ago.

It's his turn to figure out how to navigate the state's rocky political waters.

"I'm a realist, and so, candidly, there was really no secret that our Department of Health had been under a magnifying glass for the past two legislative sessions," the 49-year-old said. "And the way I think about it is that if you're under a magnifying glass on a hot Florida day, not only can people see your issues, you also can feel the heat."

Armstrong grew up in an Army family and eventually joined the service himself. He retired at the rank of colonel, directing the U.S. Army Trauma Training Center in Miami. Most recently, he served as the chief medical officer of the USF Health Center for Advanced Medical Learning and Simulation, a place where medical professionals learn new skills using high-tech simulators.

That initiative is housed in a state-of-the-art facility in downtown Tampa, and Armstrong is credited with building it from the ground up.

"It's world class; it's just hard to say too many good things about it," said Charles Mahan, who served as the state's top health officer in the late 1980s and early 1990s and is also emeritus dean at the USF College of Public Health. "I am aware that his really strong leadership made that happen and made it happen really fast."

Armstrong was doing so well at USF that it made Mahan wonder why he would leave for the Department of Health.

"He has a strong background in disaster management, and I think that's very good because I think he's taking over a disaster," said Mahan, who is among a group of public health professionals that criticized the reorganization plan.

Armstrong said the governor's office asked him to apply for the position, and he had conversations with Scott and other top officials during the selection process.

He said he believes his ability to shake up an organization and get people thinking in new ways will benefit the agency of 17,000 employees as it moves into a new era. The department will decrease from 11 divisions to eight, and its ranks will likely shrink by a few hundred employees as part of changes mandated by the Legislature.

While Armstrong is making the transition from Tampa to Tallahassee, his wife, Jodie, and 10-year-old son will continue to live in Ocala where she is an ophthalmologist. His weekend commute hasn't been changed much by the move.

During his first weeks on the job, Armstrong conducted "walk-abouts" where he met with small groups of employees to hear about the work they do. Sandra Magyar, who has been critical of the reorganization as the executive director of the Florida Public Health Association and Foundation, said she is encouraged by the new surgeon general's actions.

"That's what we can ask is that he listens, he seeks out the experts that are out there in the field and know the decisions that are made," Magyar said.

One of Armstrong's top priorities, he said, is filling the vacant positions created by the turnover and ironing out a new organizational chart. He said he will conduct national searches for some of the open positions, while others he will find from within the existing workforce. Already, he has selected a new general counsel and several other administrators.

Much of the exodus precedes him, and Armstrong said the departures aren't of concern.

"If you're reshaping a department, candidly, none of those changes should be a surprise," he said.

But Mahan wonders if Armstrong is going to have his hands tied by elected officials who are more concerned about cutting costs than strengthening the state health system. Armstrong is used to calling his own shots, Mahan said, but ultimately he will have to follow the direction of the governor and Legislature.

"I think our concern is that he's going to be very frustrated by having a surgical background, being a decision maker, a strong leader, yet he's probably not going to be able to make his own decisions," Mahan said.

Armstrong plans to be visible in the Capitol during the legislative session and available to answer questions or help shape policy. He said he has no problems asserting himself, but he happens to agree with the reorganization plan.

"I think by and large this reorganization is the right road map for the future of this department," he said.

Tia Mitchell can be reached at or (850) 224-7263.