Still standing up after sitting in

An interview with Steven Nissen, MD

January 12, 2015

By Margie Coloian

 Anybody who followed the controversy over the diabetes drug rosiglitazone (trade name Avandia) knows that Dr. Steve Nissen played a central role in the Food and Drug Administration’s decision to issue a warning about the drug’s cardiovascular risks. He was also involved in blowing the whistle in 2001 in identifying the cardiovascular risk of the pain medication Vioxx. But Nissen’s history of activism began long before.

It took him eight years to earn his bachelor’s degree at the University of Michigan because he took time off to participate in sit-ins and marches on Washington for the civil rights movement and against the Vietnam War. “I wanted to change society,” he says. “I was involved in considerable civil obedience as a young man. I’m a doctor now but I wouldn’t have traded it in for a minute.”

Being an activist at heart makes Nissen a natural to keynote at the Lown Institute third annual meeting next March in San Diego. “You can’t escape what is happening in medicine,” he says. “We spend nearly 20 percent of our GDP on healthcare, but patients don’t fare better because we work in a system that is driven by perverse incentives: we get paid more for doing more to patients. It’s got to stop.”

Nissen is still standing up—for patients. “I’ve made tough choices. I’ve battled large pharmaceutical companies but I also work closely with (pharma) industry to develop new drugs. Finding balance working with industry to find new treatments is our obligation. But when the drugs don’t work, we must tell them that they’re not beneficial to patients.”

Nissen is not shy about venting his anger over medicine practiced without evidence of efficacy. “I work in a specialty that has over-utilized coronary stenting in stable angina. This is a critical issue, and we have an ethical responsibility to patients to make sure we give them the right care.” Also citing PSA screenings and prostate biopsies, as examples, he asks, “How many things are we doing that when studied carefully, we see these interventions have led us in the wrong direction? When you do unnecessary screening, you compromise the health of patients, instead of improving it.”

Collaborating on efforts to curb overuse and misuse is what Nissen sees as a prime reason to attend the conference. “I like the fact that this conference is unlike the others I go to, which are all physician-led. I learn so much from nurses and social workers and others, people from all different walks of life,” he says. “We can learn from each other at this conference, and it’s not just about the doctors.”

Please join Dr. Nissen and our other great speakers and panelists in San Diego, March 8-11. If you haven’t registered for the conference, do so now.