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The TV Doc as Surgeon General

Whose interests will Sanjay Gupta promote?
January 8, 2009

The president-elect has paged CNN’s Dr. Sanjay Gupta and asked him to be the next surgeon general, a position that has historically been used as a bully pulpit to change health behavior. To wit: Luther Terry’s warning about cigarettes back in the 1960s, and more recently, C. Everett Koop’s efforts to reframe AIDS as a health issue instead of a moral one. Those who were too outspoken got into trouble—like Joycelyn Elders, appointed and later fired by President Clinton for talking publicly about masturbation, and Bush II appointee Richard Carmona, who said the administration prevented him from speaking out about sex education, stem cells, and other hot button health concerns.

Against this historical context, the country will have more than a passing interest in what the well-known and controversial TV doctor (controversial in some journalism circles, at least) has to say about some of the key issues of our time: the overuse of medical procedures that waste a lot of money and sometimes hurt patients, ineffective, money-wasting medical technology, universal access to medical care, and the threat of obesity and diabetes, which touches more Americans every year. All of these could cause him to tangle with powerful corporate interests, who might just complain to all the president’s men.

The media has begun to pass along laudatory remarks. The Washington Post, for example, quoted Ken Thorpe, an Emory University professor and Gupta friend, saying he is “a great voice to get the public engaged in the discussion over health care reform.” And advocacy group Center for Science in the Public Interest issued a press release Wednesday, which praises the doctor as a “skilled medical communicator” who also “has the brains and energy to be an integral part of the administration’s health policy brain trust.” Given the importance of the position, it’s fair to ask: What does Gupta’s journalism tell about the kind of doctor-in-chief he might be?

Gary Schwitzer, who publishes Health News Review, an Web site funded by the Foundation for Informed Medical Decision Making that evaluates and grades medical stories, has criticized some of Gupta’s work for not meeting standards of objectivity, fairness, honesty, and completeness. In March 2007, Schwitzer examined a story about anxiety disorders that aired on Gupta’s House Call program, offering what Schwitzer called “one of those handy self-assessments “ that allows people to diagnose “almost anything under the sun.” Gupta said that if people answered yes to any of three questions, they should see their doctor or get help from the Anxiety Disorders Association of America (ADAA).

According to Health News Review, Gupta did not mention that the ADAA’s corporate advisory council includes drug companies. Groups such as the ADAA are often used to market drugs for pharmaceutical makers. Said Schwitzer: “I worry a lot about how commercial, how unquestioning, and how cheerleading much of CNN’s medical news is. It makes me very anxious.”

Another time, Schwitzer found that Gupta and his guest gave tips on medical screening tests for men—but their advice clashed with that of the U.S. Preventive Services Task Force, a group of medical experts convened by the government to conduct rigorous, impartial assessments of scientific evidence and develop recommendations for preventive services. Many experts consider the Task Force’s work the gold standard in the field.

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This past November, researchers Steve Woloshin, Lisa Schwartz, and Ray Moynihan, who often write about conflicts in medical journalism, authored a British Medical Journal piece on the entanglements of medical journalists with pharmaceutical companies. They noted that Gupta hosted at least one CNN health program that is “funded partly though drug company advertising.” A few years back, Pfizer announced in Time that it sponsored the Paging Dr. Gupta program on CNN. Of course, corporations sponsor journalists’ programs all the time; the problem arises when journalists appear to represent the interests of the sponsor.

In 2007, left-wing publication CounterPunch attacked Gupta’s reporting on Gardisil, the cervical cancer vaccine that drug giant Merck widely and actively marketed with the help of First Lady Laura Bush and nonprofit groups funded by Merck. In a lengthy article, writer Pam Martens reported Gupta had told his audience that “trials showed the vaccine could lower cervical cancer rates by 70 percent.”

“The clinical trials for Gardasil showed no such thing,” Martens wrote. “Even Merck is not making this wild and unsupported claim.” She went on to point out that Merck was the sponsor of AccentHealth, a health-related television program produced by CNN and co-hosted by Gupta, beamed into physician waiting rooms and reaching millions of people. Martens wondered whether Gupta should have disclosed to CNN viewers that while he was “extolling of the virtues of Gardasil,” its manufacturer, Merck, was a “financial sponsor” of AccentHealth.

I have written about Gupta’s work twice for CJR. In a 2001 story about covering new medical technology, I noted that Gupta had offered his viewers a more balanced presentation of scanning machines than did Dr. Bob Arnot, the chief medical correspondent for NBC, which belonged to the same corporate family as GE Medical Systems, a scanner manufacturer.* Those entanglements again! This fall, I noted that Gupta had botched a description of John McCain’s health plan, giving CNN viewers a confusing and ultimately misleading explanation of both McCain’s proposal and the individual insurance market, where many uninsured people must turn for coverage.

It seems the President-elect wants a communicator-general to help shore up America’s dismal health statistics. But, in our money-driven health system filled with conflicts of interests, there’s a difference between being a communicator/health educator and a pitchman. Gupta has shown himself adept at both roles. We hope our colleagues continue to keep their eyes focused on Gupta, whether he becomes surgeon general or stays on at CNN.

Correction: The original version of this piece stated that Robert Hager was the NBC medical correspondent whose report on scanning machines compared disfavorably to Sanjay Gupta’s. In fact, the correspondent was Dr. Bob Arnot. Click here to return to the corrected sentence.

Trudy Lieberman is a longtime contributing editor to the Columbia Journalism Review. She is the lead writer for CJR's Covering the Health Care Fight. She also blogs for Health News Review and the Center for Health Journalism. Follow her on Twitter @Trudy_Lieberman.