In his confirmation hearing to be commissioner of the Food and Drug Administration, Dr. Martin Makary on Thursday decried the hubris of the medical establishment that he said was leading to a distrust of medical professionals by the American public.
“We need more humility in the medical establishment,” Makary told the Senate Committee on Health, Education, Labor and Pensions, which also heard the testimony of President Donald Trump’s nominee to lead the National Institutes of Health this week.
Makary, who is a professor of surgery at Johns Hopkins University and a public policy researcher, criticized the medical establishment for its lack of humility, citing statistics that showed a 30-percentage-point drop in trust in doctors and hospitals over the past several years.
“Trust in doctors and hospitals is at a crisis right now,” the public health expert asserted.
“If we have the cure for pancreatic cancer, but only 40% of the public is going to come in and take it because the rest doesn’t trust us, then that medication is only 40% effective,” Makary said as a hypothetical example of the point he was making.
Makary also promised to examine the revolving door between people who serve as health care regulators who then take roles in health care companies, citing concerns about conflicts of interests.
“We need to review the ethics policy because people see things that appear to be a cozy relationship between industry and the regulators that are supposed to be regulating the products,” he said.
The Johns Hopkins surgeon also committed to do a staffing and personnel review at the FDA, and reiterated his commitment to following the law.
“I believe in the law, and I believe in the process of having inspector generals,” Makary told Sen. Andy Kim, D-N.J.
Makary explained that he wanted to use common sense alongside science to reform the regulatory process for reviewing experimental drugs for diseases.
“We have to customize the regulatory process to the condition that we’re trying to be able to offer hope for,” Makary told Sen. Lisa Murkowski, R-Alaska.
He noted that if a condition only affects a couple of dozen people around the world, then the FDA would have to customize the regulatory process. Makary advocated for asking “big questions” that had not been asked before, such as about the long approval time for drugs.
Makary also said he would review the data on the abortifacient mifepristone.
“I have no preconceived plans on mifepristone policy except to take a solid hard look at the data and to meet with the professional career scientists who have reviewed the data at the FDA and to build an expert coalition to review the ongoing data, which is required to be collected as a part of the … the risk evaluation and mitigation strategy,” he said.
Makary said he would “follow the independent, scientific review process at the FDA” when he takes a look at the abortion drug.
The nominee also said he had no plans to dissolve the FDA’s Vaccines and Related Biological Products Advisory Committee. “I have no preconceived plans to rearrange that committee or any committee,” Makary said in response to a question from Sen. Tammy Baldwin, D-Wis.
In his opening statement, Makary noted that for 22 years he has walked into Johns Hopkins Hospital in the morning and looked at the Christus Consolator (Christ the Comforter) statue, and read Jesus’ words on the pedestal: “Come unto me all ye that are weary and heavy-laden, and I will give you rest.”
Makary expressed hope that the United States had a “generational opportunity in American health care.”
The longtime doctor appeared to be on the path to a swift confirmation. He received relatively friendly questions from Republican swing votes on the committee: Murkowski and Sen. Susan Collins, R-Maine. Collins in particular said she was “delighted” in Makary’s interest in working with her on diabetes treatment.
