Medical Schools Go Better With Pepsi?

This is not a new story, but one I just discovered thanks to one of our helpful correspondents. The Associated Press reported this controversy late last year.

The dean of the University of Minnesota Medical School is defending her decision to join the corporate board of PepsiAmericas, even though doctors and public health officials increasingly name Pepsi and other sugary drinks as a major factor in rampant childhood obesity and tooth decay.

Medical School Dean Deborah Powell said it's fair to question why she would join the board of the world's second-largest maker of soft drinks.

'I really thought about that a lot,' Powell told the St. Paul Pioneer Press. 'I thought it was an opportunity for me as a health professional to have my voice heard by the leadership of a major beverage distributor with a global reach.'

Pepsi, Diet Pepsi and Mountain Dew remain its most important brands, accounting for $3 billion in U.S. sales. That could put Powell in a delicate position, on the board of a company whose success rests on products often reviled by her medical peers.

But Powell believes she can bridge the two worlds.

'The issue of children and adolescents being exposed to carbonated, sugar-filled soft drinks is one that everybody is talking about, and I think (corporate) boards have to reflect about,' Powell said. 'I think we can do it in a responsible way to ensure that the company is successful and shareholder value is maximized and people take into account responsible stewardship.'

Like all outside directors, Powell will be paid in cash and company stock for her board service. That includes a $30,000 annual retainer, $2,000 for each board meeting she attends and $60,000 in stock.

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.