Monday, March 5, 2007

It’s the Ick Factor…
BigU MedSchoolDean Sits on the Pepsi Board

Mr. B. has previously commented on the embarrassing situation at BigU where the med school dean has accepted a position on the board of a company whose products are major contributors to the obesity epidemic and the rotting of children's teeth... Mr. B. does not get the Pioneer Press and thanks a colleague for bringing the following to his attention.

Today the Pioneer Press published a follow up article on the situation:

Posted on Mon, Mar. 05, 2007

U medical dean's Pepsi connection splits peers

Powell sees board role as chance to promote nutrition; critics say she's being used

Pioneer Press

Three months after Powell signed on with PepsiAmericas, though, the questions haven't ebbed. Outside critics continue to ask why a high-profile state health official would join with a firm whose main products are linked to childhood obesity and diabetes. One U researcher wants a "serious conversation" about the ethics of corporate consulting.

Powell said she wanted to be a voice for nutrition in the boardroom. She and her boss — who backs her decision — say the PepsiAmericas position is proper and valuable to the university.

That may not put the matter to rest. The appointment has wound itself into the national debate over how food and soft-drink makers do business. The basic questions: Can a doctor take money from a corporation but stay independent? Is joining a corporate board equal to endorsing its products?

But Robert Jeffery, a nationally known researcher and a director of the Obesity Prevention Center in the U's school of public health, worries Powell's PepsiAmericas duty ultimately may hurt the university.

"There is a level of 'ick' among quite a few faculty and students here," Jeffery said. "There definitely are some sour feelings. When you're talking about some of the most powerful people in the university backing it, it makes it distasteful."

Food companies have recruited doctors in recent years to serve on nutrition advisory boards and help with "health and wellness" campaigns. University of California San Francisco Medical School dean and former FDA chief Dr. David Kessler, who spoke at the U two weeks ago on the "obesity epidemic," is an adviser to soda and snack food giant PepsiCo.

Powell's position is different. As a corporate director, she's responsible for directing PepsiAmerica's management and the company's long-term success for shareholders.

The basic dilemma, though, is the same. Can a doctor bridge both worlds?

"Ultimately, it involves a personal risk-benefit calculation of sorts: the trade-off between risk of perceived erosion of credibility and objectivity versus prospects of potential benefit for the public good," said Dr. Michael McGinnis, a senior scholar with the national Institute of Medicine and chairman of its children's food-marketing committee, a panel that in 2005 concluded industry marketing and sales practices were putting "children's long-term health at risk."

PepsiAmericas chief executive Robert Pohlad serves on the dean's board of visitors for the U medical school and asked her to join his corporate board. [You roll my log and I’ll roll yours ?] The company's top management works out of Minneapolis.

Like other outside directors, Powell will be paid in cash and PepsiAmericas stock for her service on the beverage company's board, including a $30,000 annual retainer, $2,000 for each board meeting attended and $60,000 in stock.

Powell said the money didn't factor into her decision. "I didn't know before I went on the board that I would be paid," she said. [This is incredible. Either the dean is extremely naive or...]

Some advocates believe health leaders are naive to think they can change the dynamic in the executive suite.

"When an expert joins this kind of board, clearly it's going to compromise their ability to speak out," said Michele Simon, author of "Appetite for Profit," a book that accuses giant food companies of preaching public health while pursuing strategies that undermine it.

Putting doctors on boards is part of food company strategy to protect their public relations image, she said. PepsiAmericas, she added, now has "the dean of one of the most prestigious medical schools in the country.”

"It seems to me like a very appropriate role for the university, providing there are no conflicts of interest that haven't been disclosed," Cerra [senior vice president for health sciences] said. Citing his travel experience in remote areas of the world, Cerra added he was "awfully glad there are companies like Coke and Pepsi around" to provide a source of drinkable liquid and electrolytes in those regions. [I never realized what humanitarians the Coke and Pepsi folks are; a cynic might wonder if Coke and Pepsi were specifically concocted for this purpose? A long stretch, I am afraid, at justification.]

Powell said she finds it insulting that anyone would think she'd use her position on the PepsiAmericas board to interfere with or inhibit obesity studies or any other research at the U. [Classic straw man argument]

After two board meetings, Powell said, she's already come away with a useful tool from the corporate world. PepsiAmericas, she said, does an excellent job in succession planning for top management, a practice she said she can use in her work at the U. [Maybe she can use this valuable experience in planning for her own succession?]

"Denial, it's not just a river in Egypt."

Other Voices, Other Words

It is not too difficult to find further commentary out there on the Electronic Rialto about this sad situation. Many of them are nasty. None seem to support MedSchoolDean's position (and that of Dr. Cerra) other than an endorsement by a soft-drink bottling organization. Two examples follow.

Saturday, March 03, 2007
Pepsi: Good for What Ails You

Roy Poses, as usual, has a great take on a story that you just could not have made up, even if you tried your hardest.

Deborah Powell, the Dean of the University of Minnesota Medical School, has taken a board of directors position for PepsiAmericas, which is interesting considering that Pepsi consumption promotes both tooth rot and obesity. Don't get me wrong, there is such a thing as responsible Pepsi consumption, but should a Med School Dean be in the position of helping to maximize Pepsi sales? Perhaps she can also be on the Board of Philip Morris or Coors?

Read the whole story, then roll your eyes and/or bang your head, as you deem appropriate.

Thursday, March 01, 2007
Medical Schools Go Better With Pepsi?

With all due respect, I do not believe Dean Powell understood the responsibilities of a director of a public, for-profit company. Her job is not to "make her voice heard" about or thus advise the company about public health or health care policy. Her job is to take fiduciary responsibility for the company for the benefit of its stockholders. Her job is to maximize the financial performance of the company, whether or not doing so is in accord with her, or anyone's ideas about ideal health policy. That is why her new position could lead her into conflicts of interest.

I wonder whether leaders of academic health care who have more acute conflicts of interest, because they also are directors of pharmaceutical, biotechnology, medical device, managed care, or contract research companies, may similarly misunderstood, or rationalized their corporate responsibilities.

If so, they ought to be better informed. But as long as they accept fiduciary responsibility for for-profit health care companies, they are liable to acute conflicts of interest between those responsibilities and their responsibilities to uphold the academic health care mission, which requires putting the care of individual patients first, and creating and disseminating knowledge through free enquiry.

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