A former major general in the U.S. Army Reserve (1962 to 1993), he has worked primarily in public health for over thirty years.

[4][5][6] In January 2009, instead, Bush appointed Holsinger to fill a vacant unpaid position on the President's Council on Physical Fitness and Sports to expire May 2010.

Additionally, he holds master's degrees in hospital financial management from the University of South Carolina, as well as biblical studies from the Asbury Theological Seminary.

[2][9] He served as a surgical resident at Duke University Medical Center and Shands Teaching Hospital where he was also a fellow in Cardiology.

[2] In 1990, President George H. W. Bush appointed Holsinger as Chief Medical Director of the VA (title changed to Under Secretary of Veterans Affairs for Health in 1992).

[11] He implemented the joint VA and Department of Defense Contingency Hospital System, which could provide 25,000 beds within seventy-two hours for soldiers fighting in Kuwait during the first Iraq War.

[14] When Holsinger assumed the post of Chief Medical Director, the VA was criticized for the quality of the care it provided.

Holsinger helped the university obtain a USAID grant to build the facility, which houses one of the few AIDS laboratories in southern Africa.

In 2011, Holsinger was inducted into University of Kentucky College of Public Health Hall of Fame for his service and dedication.

[22] Holsinger served as Secretary of the Cabinet for Health and Family Services for Kentucky under Governor Ernie Fletcher.

He recommended a new professional structure based on teamwork between physicians and "fair access to health care for all Americans.

[3] Holsinger was supported by the American College of Physicians and former Surgeons General C. Everett Koop and Joycelyn Elders.

[31][32] In October 2007, Scripps Howard News Service reported that the nomination was in trouble though he retained the support of several Republicans and the White House.

[33] On November 16, 2007, The Politico and the Los Angeles Times reported that due to rumors that Holsinger would be recess appointed, Senate Majority Leader Harry Reid would convene the chamber several times during the two-week Thanksgiving break, effectively avoiding adjourning the Senate and preventing any recess appointment.

The committee's Republican ranking member said Holsinger's lack of response was "not helpful" while the editorial board of Kentucky's Courier-Journal characterized it as "disrespectful" and "baffling".

[38][39][40] The nomination was never voted on by the Senate and afterwards, in January 2009, Bush appointed him to fill a vacant unpaid position on the President's Council on Physical Fitness and Sports to expire May 2010.

Kevin Naff, editor of the LGBT newspaper, the Washington Blade, charged that Holsinger has a "long record of anti-gay bias.

"[41] Paul Weyrich, the conservative commentator, said opposition to Holsinger's nomination amounted to an assault on religious freedom.

J. Philip Wogaman, the main writer for the committee, said Holsinger imposed his views of homosexuality in the report.

[6] According to Wogaman, Holsinger resigned after he anticipated that the committee was preparing to support the moral dignity of non-promiscuous homosexuality.

[45] Supporters of Holsinger's nomination defended the paper as a review of the relevant medical literature at that time.

In 2005, the court defrocked Irene Elizabeth Stroud, an openly lesbian minister, and in a separate case reinstated a pastor who had been suspended for refusing to allow a gay man to join his congregation.

[62] Two days before the HELP confirmation hearing, former Surgeon General Richard Carmona went public with claims that the Bush Administration censored his speeches and buried his scientific reports.

[66] When asked about this at the hearing, Holsinger said, "If I were faced with a situation that I felt I could not in good conscience do, I think I have a clear response to that.