Marcia Angell
Encyclopedia
United States
The United States of America is a federal constitutional republic comprising fifty states and a federal district...
physician, author, and the first woman to serve as editor-in-chief of the New England Journal of Medicine
New England Journal of Medicine
The New England Journal of Medicine is an English-language peer-reviewed medical journal published by the Massachusetts Medical Society. It describes itself as the oldest continuously published medical journal in the world.-History:...
(NEJM). She currently is a Senior Lecturer in the Department of Social Medicine at Harvard Medical School
Harvard Medical School
Harvard Medical School is the graduate medical school of Harvard University. It is located in the Longwood Medical Area of the Mission Hill neighborhood of Boston, Massachusetts....
in Boston, Massachusetts.
Biography
After completing undergraduate studies in chemistry and mathematics at James Madison UniversityJames Madison University
James Madison University is a public coeducational research university located in Harrisonburg, Virginia, U.S. Founded in 1908 as the State Normal and Industrial School for Women at Harrisonburg, the university has undergone four name changes before settling with James Madison University...
in Harrisonburg, Virginia
Harrisonburg, Virginia
Harrisonburg is an independent city in the Shenandoah Valley region of Virginia in the United States. Its population as of 2010 is 48,914, and at the 2000 census, 40,468. Harrisonburg is the county seat of Rockingham County and the core city of the Harrisonburg, Virginia Metropolitan Statistical...
, Angell spent a year as a Fulbright Scholar
Fulbright Program
The Fulbright Program, including the Fulbright-Hays Program, is a program of competitive, merit-based grants for international educational exchange for students, scholars, teachers, professionals, scientists and artists, founded by United States Senator J. William Fulbright in 1946. Under the...
studying microbiology in Frankfurt, Germany. After receiving her M.D. from Boston University School of Medicine
Boston University School of Medicine
Boston University School of Medicine is one of the graduate schools of Boston University. Founded in 1848, the medical school holds the unique distinction as the first institution in the world to formally educate female physicians. Originally known as the New England Female Medical College, it was...
in 1967, Angell trained in both internal medicine
Internal medicine
Internal medicine is the medical specialty dealing with the prevention, diagnosis, and treatment of adult diseases. Physicians specializing in internal medicine are called internists. They are especially skilled in the management of patients who have undifferentiated or multi-system disease processes...
and anatomic pathology
Pathology
Pathology is the precise study and diagnosis of disease. The word pathology is from Ancient Greek , pathos, "feeling, suffering"; and , -logia, "the study of". Pathologization, to pathologize, refers to the process of defining a condition or behavior as pathological, e.g. pathological gambling....
and is a board-certified
Board certified
Board certification may refer to:* Board certification, for physicians in an area of medical specialization.* Nursing board certification, for nurses who obtain additional specialty training....
pathologist. She joined the editorial staff of NEJM in 1979, and became executive editor in 1988 and interim editor-in-chief from 1999 until June 2000.
Angell is a frequent contributor to both medical journals and the popular media on a wide range of topics, particularly medical ethics, health policy, the nature of medical evidence, the interface of medicine and the law, and end-of-life healthcare. Her book, Science on Trial: The Clash of Medical Evidence and the Law in the Breast Implant Case (1996) received critical acclaim. With Stanley Robbins and, later, Vinay Kumar, she coauthored the first three editions of the textbook Basic Pathology. She has written chapters in several books dealing with ethical issues in medicine and healthcare.
Angell is a member of the Association of American Physicians
Association of American Physicians
The Association of American Physicians is a medical society founded in 1885 by the Canadian physician Sir William Osler and six other distinguished physicians of his era, for "the advancement of scientific and practical medicine." Election to the AAP is an honor extended to individuals with...
, the Institute of Medicine
Institute of Medicine
The Institute of Medicine is a not-for-profit, non-governmental American organization founded in 1970, under the congressional charter of the National Academy of Sciences...
of the National Academy of Sciences
United States National Academy of Sciences
The National Academy of Sciences is a corporation in the United States whose members serve pro bono as "advisers to the nation on science, engineering, and medicine." As a national academy, new members of the organization are elected annually by current members, based on their distinguished and...
, the Alpha Omega Alpha National Honor Medical Society, and is a Master of the American College of Physicians
American College of Physicians
The American College of Physicians is a national organization of doctors of internal medicine —physicians who specialize in the prevention, detection, and treatment of illnesses in adults. With 130,000 members, ACP is the largest medical-specialty organization and second-largest physician group in...
. She is also a fellow of the Committee for the Scientific Investigation of Claims of the Paranormal
Committee for the Scientific Investigation of Claims of the Paranormal
The Committee for Skeptical Inquiry , formerly known as the Committee for the Scientific Investigation of Claims of the Paranormal , is a program within the U.S...
and is an outspoken critic of medical quackery
Quackery
Quackery is a derogatory term used to describe the promotion of unproven or fraudulent medical practices. Random House Dictionary describes a "quack" as a "fraudulent or ignorant pretender to medical skill" or "a person who pretends, professionally or publicly, to have skill, knowledge, or...
and the promotion of alternative medicine
Alternative medicine
Alternative medicine is any healing practice, "that does not fall within the realm of conventional medicine." It is based on historical or cultural traditions, rather than on scientific evidence....
.
Tenure as NEJM editor-in-chief
In 1999, Jerome P. Kassirer, M.D., resigned as NEJM's editor-in-chief over a management dispute with the Massachusetts Medical SocietyMassachusetts Medical Society
The Massachusetts Medical Society is the oldest continuously-operating state medical society in the United States. Incorporated on November 1, 1781, by an act of the Massachusetts General Court, the MMS is a non-profit organization that consists of approximately 22,000 physicians, medical students...
, the journal's publisher. NEJM is the oldest medical journal in North America. The dispute was over the Society's plan to use the journal's name to brand and market other sources of healthcare information. Kassirer and Angell were opposed to the plan, because they feared it would lend unearned credibility to health information that has not gone through rigorous peer-review implied by the NEJM label.
The Society denies that this was the reason for the dispute. Angell agreed to serve as interim editor-in-chief until a new editor could be found which was a total of less than a year. She retired from the journal in June 2000 and was replaced by Jeffrey Drazen, M.D. Angell is the only woman to have served as editor-in-chief of the journal since it was founded in 1812.
Critic of U.S. healthcare system
Marcia Angell has long spoken frankly of its unhealthy shortcomings. The American healthcare system is in serious crisis, she stated in a PBSPublic Broadcasting Service
The Public Broadcasting Service is an American non-profit public broadcasting television network with 354 member TV stations in the United States which hold collective ownership. Its headquarters is in Arlington, Virginia....
special: "If we had set out to design the worst system that we could imagine, we couldn't have imagined one as bad as we have." In the PBS interview, she urges the nation to scrap its failing healthcare system and start over:
Our health care system is based on the premise that health care is a commodity like VCRs or computers and that it should be distributed according to the ability to pay in the same way that consumer goods are. That's not what health care should be. Health care is a need; it's not a commodity, and it should be distributed according to need. If you're very sick, you should have a lot of it. If you're not sick, you shouldn't have a lot of it. But this should be seen as a personal, individual need, not as a commodity to be distributed like other marketplace commodities. That is a fundamental mistake in the way this country, and only this country, looks at health care. And that market ideology is what has made the health care system so dreadful, so bad at what it does.
Critic of the pharmaceutical industry
Angell is a critic of the pharmaceutical industry. With Arnold S. Relman, she argues, "The few drugs that are truly innovative have usually been based on taxpayer-supported research done in nonprofit academic medical centers or at the National Institutes of Health. In fact, many drugs now sold by drug companies were licensed to them by academic medical centers or small biotechnology companies." The pharmaceutical industry estimates that each new drug costs them $800 million to develop and bring to market, but Angell and Relman estimate the cost to them is actually closer to $100 million. Examples are imatinibImatinib
Imatinib is a drug used to treat certain types of cancer. It is currently marketed by Novartis as Gleevec or Glivec as its mesylate salt, imatinib mesilate . It is used in treating chronic myelogenous leukemia , gastrointestinal stromal tumors and some other diseases...
(Gleevec), zidovudine
Zidovudine
Zidovudine or azidothymidine is a nucleoside analog reverse-transcriptase inhibitor , a type of antiretroviral drug used for the treatment of HIV/AIDS. It is an analog of thymidine....
(AZT) and erythropoietin
Erythropoietin
Erythropoietin, or its alternatives erythropoetin or erthropoyetin or EPO, is a glycoprotein hormone that controls erythropoiesis, or red blood cell production...
(Epogen). An unpublished internal NIH study in February 2000 of the 5 top-selling drugs in 1995 (Zantac, Zovirax, Capoten, Vasotec, and Prozac) found that 16 of the 17 key scientific papers leading to the discovery and development came from outside industry
.
In 2004, she published The Truth About the Drug Companies: How They Deceive Us and What to Do About It.
Angell's position has been challenged by Benjamin Zycher, senior fellow at the pharmaceutical industry-funded Manhattan Institute
Manhattan Institute
The Manhattan Institute for Policy Research is a conservative, market-oriented think tank established in New York City in 1978 by Antony Fisher and William J...
, who argues that research funded by the government produces excellent basic science and even early (and unusable) versions of drugs, private investment and industrial skills are needed to produce practical products. For instance, developing mass production methods (for erythropoietin), and developing drugs without limiting adverse effects (for antidepressive drugs), selecting which drugs to test in clinical trials, and funded the clinical trials, are most commonly done by industry - not in basic research labs funded by the government.
Thoughts on alternative medicine
Marcia Angell is also a critic of the current categorization of alternative medicineAlternative medicine
Alternative medicine is any healing practice, "that does not fall within the realm of conventional medicine." It is based on historical or cultural traditions, rather than on scientific evidence....
. In a 1998 NEJM editorial she wrote with Jerome Kassirer, they argued:
- It is time for the scientific community to stop giving alternative medicine a free ride... There cannot be two kinds of medicine — conventional and alternative. There is only medicine that has been adequately tested and medicine that has not, medicine that works and medicine that may or may not work. Once a treatment has been tested rigorously, it no longer matters whether it was considered alternative at the outset. If it is found to be reasonably safe and effective, it will be accepted.
Awards and honors
In 1997, Time magazine named Marcia Angell one of the 25 most influential Americans.Works
- Science on Trial: The Clash of Medical Evidence and the Law in the Breast Implant Case. W. W. Norton & Company, 1997
- The Truth About the Drug Companies: How They Deceive Us and What to Do About It. Random, 2004
External links
- "The Truth About Drug Companies" (Video, 52 min.) Angell's lecture at the University of Wisconsin-Madison's Health Sciences Learning Center on November 2, 2007.
- Search PubMed for Angell's publications
- Where's the Evidence? - Marcia Angell interview.
- Olson, Walter (November 11, 1996). "Review of Marcia Angell, Science on Trial" in the National ReviewNational ReviewNational Review is a biweekly magazine founded by the late author William F. Buckley, Jr., in 1955 and based in New York City. It describes itself as "America's most widely read and influential magazine and web site for conservative news, commentary, and opinion."Although the print version of the...
- "Frontline" interview with Marcia Angell
- Quotes by Marcia Angell
- Angell article archive from The New York Review of BooksThe New York Review of BooksThe New York Review of Books is a fortnightly magazine with articles on literature, culture and current affairs. Published in New York City, it takes as its point of departure that the discussion of important books is itself an indispensable literary activity...