As you no doubt have heard, the healthcare blogosphere has been seriously divided on President Obama's nomination of CNN chief medical correspondent Dr. Sanja Gupta as our next surgeon general.
Over at The American Prospect, Ezra Klein liked the pick. Klein sees the surgeon general as "the country's leading medical and lifestyle educator," and it's that role " Klein wrote, that "Gupta is uniquely positioned to fill. There's not a doctor in this country with half his media training and experience, nor one with a rolodex of editors and reporters a tenth as large." Klein also expects that Gupta will be an effective advocate for the President' s health care plan."Sanjay Gupta, arguably the nation's most trusted health care authority, will be back on TV screens arguing for Obama's universal health care plan, lending it his credibility as a doctor, a trusted media presence, and the nation's surgeon general."
Not everyone sees the charismatic 39-year-old as the country's "most trusted health care authority." Indeed, the question of "trust" is central to the debate. Gary Schwitzer, a professor at the University of Minnesota School of Journalism and Mass Communications and the mind behind the excellent Schwitzer health news blog, said he was "shocked" when he heard that Gupta has been tapped. Schwitzer has written frequently about Gupta, citing his "entanglement" with drugmakers; his "unquestioning – almost cheerleading – approach to health news coverage" ; and "some laughable, some dangerous coverage on Gupta's 'Housecall' program;" . (This last post ran under the headline "Molly Ivins would have loved this one.")
Schwitzer is not alone. Drs. Lisa Schwartz and Steven Woloshin of the Dartmouth Institute for Health Policy and Clinical Practice (and home to Jack Wennberg's famed research on overtreatment) economist Paul Krugman, respected bloggers Kevin M.D. Dr. Val, Christine Gorman and Joe Paduda as well as Boston Post columnist Peter Canellos and Chicago Tribune columnist Judy Deardoff all have raised questions about whether Gupta has the "substance," the "independent voice" the "freedom from conflict of interest," the "qualifications" the respect for "facts" and medical "evidence" that we need in a Surgeon General.
Now, the debate has taken a new turn: Earlier this week, HealthBeat reader Dr. Rick Lippin posted an open letter to President Obama and Secretary Tom Daschle on Facebook, urging them to seriously consider Secretary Dr. George Lundberg as the nation's next Surgeon General. Today, Lippin's letter became the subject of a post by Brian Klepper on The Healthcare Blog (THCB. The Gupta controversy may be heating up.
First, Lippin's letter: in it he argues that the Surgeon General should be "a physician with the gravitas and the moral credentials and authority to use this bully pulpit position to speak for science and values based public health issues for all Americans. Dr. George Lundberg fits the bill." Lippin then outlines Lundberg's credentials:
- As Editor- in-Chief of the Journal of the American Medical Association's journal, commonly known as JAMA, between 1982-1999, he made it most widely read medical journal in the world,
- In 1999 he then went onto becoming Editor-in-Chief of MEDSCAPE, the leading source of online health information and education for physicians thus establishing himself as a genuine pioneer in e-medicine.
- Before joining Jama, Lundberg was an expert in o tropical medicine and served in the US Army during the Vietnam War leaving as a Lieutenant Colonel after 11years of service. His major professional interests are toxicology, violence, communication, physician behavior, strategic management and health system reform" –intellectual interests that would stand him in good stead as this country's Surgeon General.
- Finally, Lundberg is an inspiring, persuasive speaker who, Lippin notes, "has used his well honed communication skills in addressing both professional and public audiences live and in all categories of the electronic media.
Lippin concludes: "we have a genuine crisis on many levels in US Medicine. We need desperately for the medical profession to regain its moral and ethical foundations and furthermore we also need medical leaders who must regain the trust of the American Public which has been dangerously eroded.
Let me add that I know Dr. Lundberg. I have read his fine book, Severed Trust; I quote him in Money-Driven Medicine. I have met him and have the greatest respect for his courage, integrity and deep intelligence.
Meanwhile, I am troubled by Dr. Gupta's nomination because I have heard him offer medical advice on CNN that contradicts the best medical evidence and evidence-based guidelines available. Perhaps he is right, and the guidelines are wrong. But he should at least disclose what the National Services Preventive Task Force is saying. Too often, Gupta seems to be promoting the products or treatments he recommends, while dismissing safety concerns. As I have written before, we need a health care system that is designed to serve the interests of patients-ahead of the interests of those who profit from our bloated $2.3 trillion healthcare system.
In the past, the U.S. Surgeon General has stood up to a U.S. President to insist that we take AIDS seriously; he has stood up to the cigarette industry to proclaim the dangers of tobacco. As we move toward health care reform, we need a surgeon general who is more than a "lifestyle counselor." The Obama administration will need a Surgeon General able and willing to take on the many vested interests who will fight reform as they try, with all of the resources at their disposal, to protect their pot of gold. A Surgeon General could help rally the American public, and in so doing, force Congress to stand up to the lobbyists.
But how can the Surgeon General do that if he has already known as the TV counselor who has close ties to Merck-and , who, in 2003, dismissed the risk that Merck's block-buster drug Vioxx increased the chances of heart attacks?
Less than a year later the drug would be withdrawn from the market, and Merck would be accused of concealing the thousands of heart attacks and strokes caused by the drug.
In part 2 of the this post, I will tell you more about Professor Gary Schwitzer and why he was "shocked" by Gupta's appointment –as well what Gupta's other critics have to say about him. I'll also quote those who support Gupta, tell you a little more about Lundberg, and leave it to you to decide who you would prefer as Surgeon General: Sanjay Gupta or George Lundberg?