As a medical student in San Francisco, where she edited the student newspaper, Kim Thorburn wrote an article headlined, “Professors take money from drug companies.”

As a physician and opponent of capital punishment, she joined in a lawsuit against the California Department of Corrections, aimed at ending physician participation in executions.

As the creator of a health care system for prisons in Hawaii, she spoke out against inhumane treatment of inmates in that state.

All that happened before 1997, when the Spokane Regional Health District hired Thorburn as public health officer. Within months she had rankled tourism promoters and the restaurant community when she responded to a hepatitis outbreak with a loud call for vaccinations, first for food handlers, then for the public at large.

Thorburn hasn’t tempered her style in the nine years she’s been here, and now it’s uncertain if she’ll make it to 10. Her candor and lack of political prowess are wearing thin with some of the supervisors who hold her job in their hands.

She has been working under a Health Board vote of no confidence since 2004, and a recent evaluation shows that although her staff and the public give her decent marks (80 percent), her supervisors remain critical (65 percent). They criticized her for everything from “California casual” attire to being “unresponsive to opinions that vary from her own.”

Even her critics, however, concede her professional credentials are solid. In that area and in her commitment to public health, says County Commissioner Todd Mielke, chairman of the Health Board, there is no problem.

The difficulty, it seems, arises from her relationship with the board.

Indeed, she has been no more obsequious to them than she was to the medical school faculty in San Francisco. She has squabbled – quite publicly – with former County Commissioner Kate McCaslin over regulation of latte stands. And with Commissioner Mark Richard over her perception that budget and staffing cuts reflected a lack of commitment to public health. (That and Richard’s sense that she snubbed him at a public luncheon.) And she irked Mielke with the way she reacted to a potential sale of the Health Building to Kendall Yards developer Marshall Chesrown.

No doubt, Thorburn could save herself considerable grief by keeping her controversial ideas to herself, or at least between her and the politicians. Going public keeps getting the public health officer in trouble – which probably helps explain why the public appreciates her more than the politicians do.

Thorburn may be abrupt, if not abrasive. And she’s hardly infallible. But she enjoys sufficient professional respect to be named chairwoman of the State Health Board by Gov. Chris Gregoire. Her counterpart in Snohomish County, Dr. M. Ward Hinds, wrote a letter to the editor, published last week, warning that “the health district would lose an excellent public health professional if Dr. Thorburn were to leave.”

In 1998, The Spokesman-Review published a profile describing Spokane County’s new health officer as “the anti-politician, a wash-and-wear woman in a faded blue corduroy suit who has a talent for giving her opinion, regardless of the consequences.”

If that person has mismanaged her agency, or failed to serve public health, the Health Board should hold her accountable. If her candor and her wardrobe are the most they can come up with, though, that’s no justification for getting rid of competence.