Does Dr. Murthy Have Conflicted Interests?

The Washington Post has reported on Dr. Murthy’s financial disclosure statement, which can be found here if you have time on your hands. Here from Medpage is the short version.

“…Vivek Murthy, MD, nominated for Surgeon General … received 2.6 million dollars in pandemic consulting fees and speaking engagements since January 2020. Murthy received $400,000 from Carnival cruise lines for consulting, over $400,000 in cash and another $400,000 worth of stock from Airbnb, nearly $300,000 from Estee Lauder, and $600,000 from Netflix. The article notes, "most of Murthy's consulting work came after Biden effectively clinched the Democratic nomination in April 2020… and he was sometimes touted in speeches as a Biden adviser." 

You might also remember that Dr. Murthy was a bit of a poster child for “doing the right thing” when he was dismissed by President Trump in April 2017 for his openly contrary views on medical issues long before we dreamed of COVID-19.

ProPublica, which has made a bit of a cottage industry over pharmaceutical and medical device payments to physicians, has been silent on the disclosures. An unnamed HHS official told the Washington Post that “If confirmed to serve for a second time as Surgeon General, Dr. Murthy will provide the public with clear, accurate health information to keep them safe, rooted only in facts and science.”

Let me be very clear at this point. I have absolutely no problem with Dr. Murthy’s income or its sources, and I do not believe that he will compromise patient care or safety. But perhaps we need to spend a moment talking about the other physicians, and now nurses and physician assistants vilified for getting a lunch brought in while working by some pharmaceutical or medical device representative.

What are all those payments buying?

I think it is unrealistic to believe that Dr. Murthy’s fee reflects his medical advice to these companies. Certainly, that can be obtained at a fraction of the cost from a reasonable infectious disease expert. Instead, or perhaps, in addition, they are paying for his regulatory advice and eminence. He has, to use an old-fashion analogy, the Rolodex of numbers and “actors” necessary to navigate Washington’s new regulatory environment. Is that so much different than when a pharmaceutical or device company pays a “thought leader” for their reputational imprint and navigational skills among physicians?

If there is no difference, then why are ProPublica and Public Citizen so silent? If there is a difference, they can then share how Dr. Murthy is absolved and some poor doctor getting a few meals for his local influence is damned by innuendo. If a few meals alter our prescription habits, what does $2.6 million do to our thinking? The truth is that some doctors are influenced by payments and by flattery, and some may make bad judgments. But if that is such a significant problem, then doesn’t Dr. Murthy have some explaining to do? You can’t have it both ways. The truth is that most physicians are decent folks, and groups like ProPublica should stop casting shadows when they claim to be casting sunlight.