Thursday, January 08, 2009

Sanjay Gupta, Big Pharma flack

By Michael J.W. Stickings

I'm still not sold on Sanjay Gupta for surgeon general. In fact, the more I think about it, the more I dislike the very idea of putting Gupta in charge of public health.

As I wrote on Tuesday, when the story broke, Dr. Gupta "seems to be very much a part of, as well as a defender of, the status quo, namely, the corporatized health care system controlled by Big Pharma and the HMOs."

And, indeed, more is coming out about his seemingly unethical (or at least questionable) dealings. For example, at TNR's The Plank today, Marin Cogan and Suzy Khimm add that he is "no stranger to the ethically sticky situation physicians often find themselves in with drug companies":

For over six years, Gupta has been co-hosting "AccentHealth" -- a CNN television segment beamed straight into doctors' waiting rooms, sponsored in part by many of the major pharmaceutical companies. Touted on its website as an "integrated marketing opportunity" that allows companies to deliver their message "in a trusted environment," the show has been underwritten by drug industry leaders Aventis, Pfizer, Procter & Gamble, Merck, and Warner Lambert.

At the same time, Gupta has been appearing on CNN's primary broadcasts as an ostensibly objective medical authority, discussing the drugs produced by the very same pharmaceutical companies.

In other words, Gupta takes money from Big Pharma and then promotes their products both directly to patients and more broadly (and untransparently) in his capacity as a celebrity doctor on television. And he has done this, no doubt much to his profit, for drugs like Lipitor (cholesterol), Aventis (allergies), and Gardasil (HPV).

I realize that the world of health care ethics, not least where Big Pharma is concerned, is rather murky. The fact is, like it or not, these companies, and others like them, do manufacture and market drugs that work -- and that we would not want to do without. I do not necessarily fault them for wanting to sell their products, and to target both practitioners and patients. I would not want a doctor to prescribe a drug simply because he or she accepts what he or she is told unthinkingly, but if a doctor, like Gupta, thinks a drug is effective, then he or she should be able to speak positively to it.

As Cogan and Khimm point out, though, "[a] growing body of evidence... suggests American medicine is far too aggressive, which leads to higher costs and, all too frequently, actual harm for patients. If Obama wants to reform the health care system, his surgeon general will have to push back against both the pharmaceutical companies that promote ineffective treatments and the doctors who prescribe them."

The problem is that Big Pharma and the HMOs control health care in the U.S. -- and many doctors just buy into the marketing machine. Gupta may not be your basic GP -- he is surely more aware of the big picture than most -- but what he is instead is a significant contributor to the problem, a telegenic broadcaster with the credibility that comes from being on television. It would be one thing if he simply reported on the pharmaceutical industry and its products from a perspective of balanced detachment. But he doesn't. He actively tries to sell those products, and, in so doing -- and without being open about his connections to Big Pharma -- he's part of the marketing machine at the core of the problem.

Gupta has a lot going for him -- not least that he's an engaging communicator. But surely there is someone else -- a public health advocate, a leading researcher, an expert from the CDC -- who is qualified for the job and who hasn't been shilling for, and profiting off, Big Pharma. At the very least, if his nomination does go forward, Gupta should be required to answer for what he has been doing.

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