Alabama is the only state in the nation where the top health organization is not led by someone appointed by the governor or by a board that is appointed by the governor.

Alabama law designates “the State Board of Health as an advisory board to the state in all medical matters, matters of sanitation, and public health. The Medical Association, which meets annually, is the State Board of Health.” This “Medical Association” is none other than the Medical Association of the State of Alabama (MASA), the association of some of the state’s physicians. MASA operates just like any other professional association does: it has its own leadership, its own practices, and its own decision-making bodies – all of which are determined not by the governor or by the people of Alabama, but solely by the medical practitioners who populate the group’s membership rolls. The Medical Association is also a registered principle (an organization that hires lobbyists) and has, as of March 2021, six registered lobbyists. In fact, advocacy is, according to their website, the “Medical Association’s primary focus.” What about the State Health Officer? Maybe he’s chosen by the governor or elected? Not quite.The State Health Officer is elected by the State Committee on Public Health. Members of the State Committee on Public Health are selected by the State Board of Health, which is the Medical Association. This dynamic is similar with county health officers as well. The office of Chief Medical Officer in Alabama should be a cabinet level position that is appointed by the governor like his/her other cabinet officials. He or she should also be confirmed by the Senate.