CNN's Gupta: Not What the Doctor Ordered

When word leaked out that neurosurgeon and CNN journalist Sanjay Gupta was up for the Surgeon General post, many said he was a natural to be the government's top spokesperson on public health issues and a major player in crafting and selling President Obama's plan for health care reform.

In fact, Gupta would be a disastrous pick. His misleading coverage of important public health issues and sloppy evaluation of scientific evidence, as outlined below, would make him an ineffective and dangerous choice:

1) First consider Gupta's extensive coverage of autism, in which Gupta gave inappropriate credibility to those who believe that vaccines cause autism, thereby supporting controversy around the issue.

There is no controversy. Every major clinical trial and epidemiologic study conducted to examine this issue has failed to show any link, and the American Academy of Pediatrics, the Institute of Medicine, and the Centers for Disease Control all state clearly that there is no evidence for one. Instead of using his platform as a prominent journalist and physician to firmly dispel this harmful myth, Gupta made a good story out of it. There is a growing movement of parents who choose not to vaccinate their infants and young children against deadly diseases. As a result, outbreaks of measles, mumps, and pertussis are on the rise. The next Surgeon General needs to settle this issue in the eyes of the public.

2) Both Obama and the Surgeon General's likely boss, Tom Daschle, have highlighted the need for restraint from the use of unproven or unnecessary tests and procedures in an effort to reduce health care costs. However, several of Gupta's recommendations for screening tests are not based on sound evidence and depart radically from accepted norms.

For example, he has stated that men in their 30s should have routine electrocardiograms, a position rejected by the United States Preventive Services Task Force, a government panel that issues screening guidelines based on a rigorous review of scientific evidence. He also has suggested that CT scans of the heart can serve as a useful screening test for coronary disease. But this controversial and expensive technology has not yet been adequately validated and is a prime example of the epidemic adoption of a new technology without good evidence to justify its use.

3) Although an ardent supporter of new tests and treatments, especially pharmaceuticals, Gupta downplays safety risks. Many have criticized him for his reporting on Vioxx, a pain medication used for arthritis that was voluntarily withdrawn from the market in 2004 because it causes heart attacks. Although the drug's cardiac risk was well-known prior to its removal from the market, Gupta minimized these concerns by citing the lowest possible estimate for the increase in risk of heart attacks, 39 percent, rather than the middle (and most appropriate) estimate of 425 percent.

Moreover, he parroted Merck's response that the number of people with heart attacks was small and that further studies were needed. No doubt further studies were needed to allow the drug to remain on the market for five years while bringing in over $2 billion annually in sales for Merck and causing tens of thousands of excess heart attacks, according to an estimate from the FDA.

4) Just as worrisome is Gupta's involvement with Accent Health, a marketing company that offers pharmaceutical companies the opportunity to intersperse their television ads for drugs with programming hosted by Gupta, crafted specifically for physician waiting rooms. This sends a confusing message to patients and blurs the line between overt advertising and Gupta's style of pro-pharmaceutical "journalism."

5) Lastly, one cannot forget his hack job on Michael Moore's movie Sicko, which exposed some of the root causes of our national health care crisis and pointed toward a national single-payer health system as the solution. In a highly publicized on-air debate with Moore, Gupta made many erroneous statements about facts and figures, essentially calling Moore a liar, and then failed to correct himself or apologize after being revealed as wrong.

Gupta's lack of any formal public health training or experience does not in itself disqualify him as a candidate for the position of Surgeon General. But his record of sloppy and misleading reporting on multiple health issues does, and also brings into question his credibility as a journalist. The Surgeon General must be more than the cheerleader-in-chief on public health issues. The job also requires a good understanding of scientific evidence and sound judgment. Gupta has failed to demonstrate either, and I urge President Obama to nominate someone else for the position.

James Floyd, M.D., is an internist and health researcher with Public
Citizen.

Comments

[dredge]

Thank you for this post. It's clear from the instances you cited, the Gupta is in the service of the Pharmaceutical corporations. His efforts are contrary to those of a responsible physician: He is there to promote and sell any profit making incentive by the medical "industry". You are right that he is a dangerous choice. This is yet another Public Relation spokesman. Crazy how riddled with these charlatans our cultural landscape has become.

[drricklippin]

Thanks Dr. Floyd

I wrote a letter to then Pres Elect Obama and Sen Daschle "nominating" Dr George Lundberg for next US Surgeon General. The letter has been circulated widely most notably through a group on FACEBOOK entitled DR GEORGE LUNDBERG FOR SURGEON GENERAL. My letter and other supporters have apppeared on several good blog sites in support of Dr. Lundberg

If you wish to work with me you can reach me at [e-mail]

THANKS!

Dr. Rick Lippin
Soouthampton,PA

[offred]

I remember thinking at the time that nominating Gupta was like nominating a celebrity just because he had name recognition. I saw his response to Michael Moore's Sicko and I was appalled at Gupta's lack of honesty.

[James Floyd, M.D. - Huffpost Blogger]

Gupta's coverage of Sicko was shameful. Based on that, and his misleading coverage of John McCain's health care proposals during the presidential race, it is clear that he is not a supporter of true universal health care under a single-payer system, and that he buys into the myth that a market-driven system can solve our health care crisis. This is especially concerning, as he was also offered a top post in the new White House Office of Health Reform, and will probably have some influence on the President's health care form proposal.

[offred]

Gupta seemed like a lame choice. How about Michael Osterholm?

http://www.cidrap.umn.edu/cidrap/center/about/staff/articles/osterholm.html

[Linda Bergthold - Huffpost Blogger]

I,too, initially thought that Sanjay Gupta was an inspired choice. He can communicate about health care issues, he is a physician, and so much of the job of the Surgeon General is a bully pulpit about general public health issues. Your blog has made me rethink my initial support. In particular, I have been concerned about the fact that Daschle was buying into the autism-vaccine link, something that, as you point out, all the science has debunked. Now that Daschle is no longer "in", hopefully there will be a return to a respect for good science on this and many other issues. Whether or not Gupta is appointed, we do need a strong public health advocate in this role and someone who has respect for evidence and science.

[lightandlove]

"...all the science has debunked." Oh really? I really wonder where you 'no autism-vac­cine-link' folks look for your scientific evidence, Linda. Scientific evidence is more likely to turn up in such as case histories and toxicological studies than in statistics - especially in such a hot issue as this one. Since as we know, stats can lie, giving you the results you want. (See, eg, the flawed Denmark study, and the Fombonne study in Canada with the same sort of methodological weakness; not to mention the notorious Verstraeten study; plus others.)

When many parents, after observing their children slipping into such as ASD after their shots, have gotten positive results from biomed interventions, including chelation; when many children on the spectrum have been found to have low glutathione levels, necessary for the elimination of heavy metals/toxins; when the glutamate in the diet AND VACCINES exacerbates this subset sensitivity; when neurological-damage cases linking to vaccines have won in the Vaccine court; when those cases include the presence of antibodies to MBP, resulting in such as MS, and the same tell-tale clue found in relation to the measles component of the MMR shot in a cohort of children with ASD - and on and on in this vein, there is overwhelming evidence available that the medical profession has been remiss in its duty to investigate this clearly-suspectable link. As Dr Bernardine Healy has said.

"Respect for evidence and science" indeed.

[arturod]

Whoops. Looks like the MMR doc has been discredited. There is no evidence of any link.

http://www.dailykos.com/storyonly/2009/2/8/22165/08497/592/695030

[clevelandchick]

Dr. Floyd,

Number 4 is what worries me most though all of your reasons were expertly put. With Obama promising to keep his cabinet and administration as free as possible from influence peddling, Gupta's relationship with that company is beyond troublesome. The influence of insurance, health and pharmaceutical companies on our health system is part of the reason costs are so astronomical and citizens are not being covered or served properly.

I used to think Big Oil was the biggest our nation faced but I now believe Big Health probably causes more deaths, ruins more lives and costs us more in treasure.

Gupta is part of the machine, no doubt. And, he is adamantly against single-payer healthcare to the point he blatantly lied about Michael Moore's movie.

Obama appointing Gupta to HHS is no better than when Bush appointed one of Ken Lay's boys to the Dept. of Energy. You're putting a fox in the henhouse.

I am an Obama supporter but he needs to get off this bi-partisan kumbaya kick....he's not going to get anything done with picks like Gupta. The Fed is too big, he cannot micromanage every agency and those with agendas counter to that he promised the people will sabotage it.

[schatsie]

It really is pretty much a tie between healthcare and energy costs according to the Economist Year in Figures....

[dgscol]

Tier B health care is being put in place. The high payouts from the government and insurance companies, has made it possible for doctors to take off 4/5 days a week. They are filling in with doctors from foreign countries. This will establish a Tier B system of health care. These doctors are graduated from all over the world, from places of questionable standards. This is before Obama and team can establish a new "efficient" service for health care.

[nosugrefneb]

I would keep a close eye on George Lundberg. As a disclaimer, I've worked with him closely at times, but this has only convinced me that his vast experience in conducting medical research and clinical practice, pioneering open-access publishing, holding several administrative positions, and editing major biomedical journals places him in a position as someone who is hyperaware of the state of health care in the US and who has the wherewithal to do something about it. He's not being talked about at all, but I think we should be talking more about him.

[whillice]

I like Sanjay Gupta. A LOT. Is he the right choice for Surgeon General? You've made me rethink this, so thanks for the post.

I think we can agree, though, as much as the debate on thimerosal is over, we should begin instituting the Precautionary Principle when it comes to our food, drug, and consumer product safety procedures. This should mean a pre-emptive pull of all multi-dose vaccines that use thimerosal as a preservative and use the safer alternatives.

VACCINATE YOUR CHILDREN, but insure that vaccines are safely produced.

[schatsie]

The very saddest thing about the thiomersol is that in fact it is not a preservative, the injectables actually deteriorate faster....Sorry, but mercury in our country/world is a real problem.. Think about the fish and their ingestion of mercury in the ocean from the coal mines... and aluminum and other things...almost enough to make you go vegan....

[gabberwok]

1) Most vaccines in developed countries no longer contain thiomersal as doses are kept in sterile individual use packages and no longer need an antimicrobial agent to remain potent.

2) There has never been any proven link between thiomersal (or any vaccine component) and autism, and indeed there is a large body of evidence against such a link.

Vaccines + antibiotics + smoking reduction = vast majority of lives saved by medicine.

[euthman]

I agree Chopra has a winning personality, which makes him all the more dangerous. While he does pay lip service to the scientific method, so much of his message is so far away from rational thought that he simply cannot be taken seriously by critical thinkers.

[clevelandchick]

I think you meant Gupta. (Deepak) Chopra is a religious philosopher, author, etc.

[euthman]

No, I meant Deepak Chopra. I was replying to another comment and hit the wrong "Reply" button. My apologies. I think Gupta, warts and all, would be immeasurably better for Surgeon General than Chopra.

[bloggolb]

i think gupta should go. he's too tie to the drug ad insurance companies. and if he's not a strong advocate for universal health insurance - then thats definitely not needed. there are a ot of other choices out there. i think the nyc health commesioner would be good. they have done many inovative health programs in nyc. from anti smoking to transfat etc

[ccdaddy57]

Continued from the previous post from ccdaddy57
I believe when they were first warned the autism rate was 1 in 10,000 they chose to ignore the warning, and every piece of research that they did in their words, that they said were well designed robust studies. We are learning that they were useless. So I guess we can say at the least, The Dir. of the CDC was incompatant, and at the worse the Dir. was involved in a criminal cover up. But I do believe we have given them long enough time to investigate themselves. after all would you let ENRON investigate ENRON ? also I'm afraid if we give them anymore time we won't have any children left. from 1 in 10,000 to 1 in 82 and that's not even taken into account a 4 to 1 ratio boy's to girls we in the U.S. should have the same penalties that China has, they put people to death when they are this incompatant. I think if there were consequences example from China for this kind of incompetence I believe our children would not be for sell to the highest bidder from big Pharma. as high profit guinea pigs....

[krocklin]

And in Japan exposed incompetents and criminally negligent ceos committ suicide. In this country they are allowed to stay on, keep their jets and homes in Boca Raton, and party even harder with public funds.

What a contrast in cultures. In our Republican culture to be greedy, incompetent and conniving are admired. In China and Japan it is fatal

[James Floyd, M.D. - Huffpost Blogger]

An excellent article from the NY Times a couple weeks ago (http://www.nytimes.com/2009/01/13/health/13auti.html) quoted the president of the Sabin Vaccine Institute saying “If the surgeon general or the secretary of health or the head of the C.D.C. would come out and make a really strong statement on this, I think the whole thing would go away.”

To which the acting Surgeon General Dr. Steven Galson stated "childhood immunizations are one of the greatest achievements of all time” and that “scientific evidence clearly shows that vaccines do not contribute to autism."

Conducting large clinical trials and epidemiologic studies are the way in which we confirm, and exclude, associations between exposures and diseases. Rejecting the large amount of data that strongly argue against a causal link between vaccines and autism requires a wholesale rejection of the scientific method, and puts ones of shaky intellectual footing.

It is because this is a very emotionally-charged issue that many journalists, and some public servants, are afraid to make strong statements debunking these views. President Obama should nominate someone for Surgeon general, unlike Sanjay Gupta, who has the courage to make such statements, in the interest of public health.

Undoubtedly, further research to investigate possible causes for autism is needed. But the continued hype over a possible link between vaccines and autism is simply distracting us from this.

[ccdaddy57]

This is the Dir. of the CDC 's response to the allegations that their flag ship studies were fatally flawed according to congress and the NEIHS "CDC concurs," Dr. Gerberding wrote in an undated mea culpa to Congress, (provided to me through a Capital Hill staffer)

That leaves them with nothing left! ( Nothing )

This is the CDC Dir. admitting that they have no science left to refute the autism thimerosal connection, but give them some more time, and they will produce good quality studies.

Continued

[ccdaddy57]

James Floyd, M.D I t seems you are not keeping up with that mountain of evidence against the link
between autism and vaccines. It appears that mountain has been removed .... Example and case in point ..

You who keep thinking that the science is in, your right. And it's not good for the CDC's EX DIR. This is the latest about the CDC 's science "As questionable as the US thimerosal study was, "it was an improvement on other studies, including the two in Denmark, both of which had serious weaknesses in their designs," Dr. Irva Hertz-Picciotto, Professor of Public Health at UC Davis Medical School and Chair of the NIEHS panel, told reporter Dan Olmsted at UPI.That leaves very little for the CDC to go on in terms of proving that thimerosal and autism are not associated in any way".

Continued

[euthman]

Actually, there is no "link" between autism and vaccines, as numerous studies have shown. See:

http://www.autism-watch.org/

Ed Uthman MD
Pathologist, Houston
http://web2.airmail.net/uthman

[LoveLifeLightLaughter]

I was shocked, as many were, by the Gupta possibility. Sure, he's a famous face, but long before he came to mind I was thinking of Dr. Deepak Chopra. Here's a famous, accomplished doctor with books, TV shows, and international credibility. Plus, he's 180 degrees away from Gupta on all of the issues you mentioned. Some people have tried to tuck him in with the "New Age Crazy" crowd (not that there's anything wrong with that, per se, except in the closed minds of the stodgy medical community), but he's more mainstream than anything and his core values are wellness and preventative care, not sick-care as Harkin and others so often call our current "health"care system. Besides, he's got a wicked sense of humor and is genuinely nice, while Gupta comes off as a snake oil salesman who's always got his own agenda.