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
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