Marcia Angell (; born April 20, 1939) is an American physician, author, and the first woman to serve as editor-in-chief of The New England Journal of Medicine. She is currently a Senior Lecturer in the Department of Global Health and Social Medicine at Harvard Medical School in Boston, Massachusetts.[ Biographical Sketch of Marcia Angell, M.D., F.A.C.P at the Harvard Health Caucus . Accessed September 10, 2006.]
Biography
After completing undergraduate studies in chemistry and mathematics at James Madison University in Harrisonburg, Virginia, Angell spent a year as a Fulbright Scholar studying microbiology in Frankfurt, Germany. After receiving her M.D. from Boston University School of Medicine in 1967, Angell trained in both internal medicine and anatomic
pathology and is a
board certified pathologist.
Angell is a frequent contributor to medical journals as well as in the popular media, where she has offered her perspective on topics including medical ethics, health policy, psychiatry, the opioid epidemic, 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 with Vinay Kumar, she co-authored 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, the Institute of Medicine of the National Academy of Sciences, the Alpha Omega Alpha National Honor Medical Society, and is a Master of the American College of Physicians. She is also a fellow of the Committee for the Scientific Investigation of Claims of the Paranormal and is an outspoken critic of medical quackery and the promotion of alternative medicine.
New England Journal of Medicine tenure
Angell joined the editorial staff of
The New England Journal of Medicine (NEJM) in 1979. She became Executive Editor in 1988, and served as interim Editor-in-Chief from 1999 until June 2000.
The NEJM is the oldest continuously published medical journal,
and one of the most prestigious; Angell is the first woman to have served as Editor-in-Chief of the journal since it was founded in 1812.
In 1999, Jerome P. Kassirer, M.D. resigned as NEJM's Editor-in-Chief following a dispute with the journal's publisher, the Massachusetts Medical Society, over its plan to use the journal's name to brand and market other sources of healthcare information. Angell agreed to serve as interim Editor-in-Chief until a permanent editor was chosen. She reached an agreement with the Society that the Editor-in-Chief would have authority over usage of the journal's name and logo, and that the journal's name would not be used on other products.[Scott Gottlieb (May 20, 2000). Controversy over new editor at New England Journal of Medicine page 1 . BMJ. Retrieved August 28, 2013.] Angell retired from the journal in June 2000 and was replaced by Jeffrey Drazen, M.D.
Positions
Criticism of conflicts of interest and biases in the medical establishment
In her 2009 article "Drug Companies & Doctors: A Story of Corruption", published in
The New York Review of Books (NYRB) magazine, Angell wrote:
Criticism of the Food and Drug Administration
Commenting on the 1992 Prescription Drug User Fee Act which allowed the Food and Drug Administration (FDA) to collect fees from drug manufacturers to fund the new drug approval process, Angell has stated :
Criticism of U.S. healthcare system
Angell has long been a critic of the U.S. healthcare system, claiming that the system is in serious crisis. In a PBS special in 2000, she stated: "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 urged the nation to scrap its failing healthcare system and start over:
She later reiterated these points in an NYRB review of Steven Brill's book America's Bitter Pill (2015) about the passage of the Affordable Care Act: "his description of our dysfunctional health system is dead-on. He shows in all its horror how the way we distribute health care like a market commodity instead of a social good has produced the most expensive, inequitable, and wasteful health system in the world."
Criticism of the pharmaceutical industry
Angell is a critic of the pharmaceutical industry. In a 2002
New Republic article, she and Arnold S. Relman argued that drug companies exaggerated their R&D costs in order to justify their large profits: "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."
At the time, the pharmaceutical industry estimated that each new drug cost $800 million to develop and bring to market, but Angell and Relman estimated that the cost was closer to $100 million. She continued her inquiry into industry practices, eventually authoring the book
The Truth About the Drug Companies: How They Deceive Us and What to Do About It (2004), with the following excerpt published in The New York Review of Books:
Richard Friedman, director of the psychopharmacology clinic at Weill Cornell Medical College, and a regular contributor to The New York Times science pages, criticized Angell's views as one-sided: "Dr. Angell is now doing pretty much the same thing the industry she assails has done, just the converse. Pharma withheld the bad news about its drugs and touted the positive results; Dr. Angell ignores positive data that conflicts with her cherished theory and reports the negative results.”
Views on alternative medicine
Marcia Angell is also a critic of the current categorization of alternative medicine. In a 1998 NEJM editorial, she and Jerome Kassirer asserted:
- 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 for that year.
Works
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Basic Pathology 1st edition (1971, Robbins, Stanley Leonard; Angell, Marcia); 2nd ed. (1973, Robbins, S.L.; Angell, M.); 3rd ed. (1981, Robbins, S.L.; Angell, M. Kumar, Vinay)
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External links
