Watching news coverage of the Washington/Wall Street economic maelstrom, you'd have a hard time arguing that any new cabinet or agency appointee has a harder job ahead than Treasury's Tim Geithner.


Until you come to Dr. Margaret Hamburg, the nominee for FDA commissioner, who may soon be wishing for a nice, clean assignment, like the one Hercules took on in the stables of King Augeas.


Start with an agency that is responsible for regulating everything from pet food to MRIs to ginkgo to breast implants to tanning machines to contact lenses to MRIs to our blood supply to cell phones to glaucoma drugs to stents to food labeling to importing to soap to eyeliner, and more. In all, the agency's reach touches products that account for about a quarter of all consumer spending in this country.


Now add a budget that is roundly recognized as inadequate, and that derives in large part from the very manufacturers the agency is charged with regulating. Add an increasingly cozy relationship with lobbyists, especially in light of a generally dismissive attitude toward science from the White House of the past eight years. What it adds up to is an outdated, ill-equipped agency that can't keep up with yesterday's challenges. Now, top it off with a new world of stem cell research, genomics and nanotechnology, and it's best of luck, Dr. H.


Beginnings are not times for negativity, and the early reports on Dr. Hamburg are positive and promising. Her performance as the health commissioner for New York City has won her praise.


Beginnings are also no time for thinking small. Unlike David Kessler and Mark McClellan and Andrew von Eschenbach, who were doomed from the start, let's give this commissioner a chance to succeed. Let's think big and imagine an agency that regulates only medicine and medical devices. And an entire division of that agency that monitors drugs and devices after they're approved. And a separate agency that's responsible for food safety. And since we're tossing dollars around, let's provide the new agency an adequate budget and see how that approach turns out. We already know how the alternative works.