Physician to the President

Doctors who have treated the president of the United States have had a variety of titles.^[3] Presley Marion Rixey (1852-1928), a medical inspector in the United States Navy, was the first individual to serve in a full-time capacity beginning in 1901, and is notable for serving as physician to Presidents William McKinley and Theodore Roosevelt. However, the formal title "White House Physician" was not established until after his tenure. This title was created by an act of Congress in 1928.^[4]

The White House physician has an office inside the White House. The location of their medical unit plays an important role in keeping the president of the United States healthy. They also oversee a staff that is typically composed of five military physicians, five physician assistants, five nurses, three paramedics, three administrators, and one IT manager. The physician to the president is metaphorically the "shadow of the president" because they (or one of the physicians assigned to the White House Medical Unit) are always close at hand whether the president is at the White House, overseas, on the campaign trail, or aboard presidential plane Air Force One;^[5] Daniel Ruge, for example, was nearby during the attempted assassination of Ronald Reagan in 1981, and supervised the president's immediate treatment.^[6]

The physician to the president protects the president's health. The physician to the president, together with the director of the White House Medical Unit, is also responsible for managing comprehensive medical care for the members of the president's immediate family, the vice president, and the vice president's family and providing the medical support to ensure the continuity of the presidency. The physician may also provide medical care and attention to the more than 1.5 million visitors who tour the White House each year, as well as to international dignitaries and other guests of the president.

The medical office of the White House doctor is a "mini urgent-care center" containing a physician's office, private examination rooms, basic medications and medical supplies, and a crash cart for emergency resuscitation. Air Force One is equipped with emergency medical equipment, an operating table, and operating room lights installed at the center of the presidential plane for emergency use by the White House doctor.^[5][7]

Ruge resigned after Reagan's first term and called his job "vastly overrated, boring and not medically challenging". Due to lack of space, Ruge could not attend most state dinners. He nonetheless had to be ready for emergencies and usually waited alone in his office wearing a tuxedo. However, Ruge stated that an advantage was that because of the position's prestige, "[a] president's physician can ask for anything, and he will get it. No doctor will refuse a request to consult". The White House physician can enter the Oval Office or Executive Residence at any time; Ruge sometimes invited experts visiting Washington to examine the president.^[6]