Obama’s Nominee for the VA, Robert McDonald, Former P&G CEO, Should be Held Accountable for Unethical Pharma Study

By Roy M. Poses, MD. Originally posted at Health Care Renewal.

Introduction – New Leadership for the US Department of Veterans Affairs

After reports of problems with access, manipulation of data about waiting times, and most recently “a corrosive culture,” the US Department of Veterans Affairs, the country’s large government run health system, has had a massive leadership overhaul.  President Obama’s nominee to head the agency is now Robert A McDonald, for CEO of Procter and Gamble. 

The choice of a former CEO or a large corporation was called “unorthodox” by the Boston Globe, but many saw merit in a business leader running the VA.  As reported by the Globe, House Speaker John Boehner said that as a “private sector” leader,  Mr McDonald is the “kind of person who is capable of implementing the kind of dramatic systemic change that is badly needed and long overdue at the VA.”  The Chairman of Boeing, also a member of the P&G board, hailed Mr McDonald as the person who “navigated Procter & Gamble through the difficult post-financial-crisis years, where he expanded business in developing markets and made substantial progress improving the efficiency of the company’s internal operations….” 

On the other hand, a column in the Washington Post suggested that expertise in “selling Tide and Pantene” might not be relevant to fixing the VA. Yet aside from a single article on the Ring of Fire web site, all news coverage and discussion so far has ignored Mr McDonald previous experience in health care leadership, but also that his relevant track record ought to raise questions about his fitness for the VA position.

Procter and Gamble and Health Care

According to Mr McDonald’s official P+G biography, after various roles in various countries, before becoming CEO, 

Bob returned to the U.S. as the Vice Chairman of Global Operations (2004 to 2007) and later P&G’s Chief Operating Officer (2007 to 2009).

Although not widely known as a pharmaceutical company, P&G actually had a subsidiary that made prescription drugs, which Mr McDonald sold off in 2009 (see this Wall Street Journal report.)  As we noted here, its products still include over the counter pharmaceuticals (e.g., Pepto-Bismal, Metamucil, Prilosec OTC).  Also, while Procter & Gamble does not make it very obvious, it has owned MDVIP, a company that employs physicians to provide concierge medical services, since 2010, although as Cincinnati.com just reported, it will soon sell this unit to private equity.  So during Mr McDonald’s tenure, his company was to some extent a pharmaceutical company, and a health care provider.

The Blumsohn – Procter and Gamble – Sheffield University Case

Furthermore, on Mr McDonald’s watch as Vice Chairman of Global operations and Chief Operating Officer, there was a case involving Procter and Gamble that raised multiple concerns about the ethics of its pharmaceuticals operations.  We first posted about the case in 2005 (here).  For all relevant posts, look here. In 2009 we described the case thus,

The case involved suppression and manipulation of research, ghost-writing, institutional conflicts of interest, and attempts to silence a whistle blower. It provides lessons about the downsides of letting commercial firms sponsor and hence control human research designed to evaluate the products or services they sell; and of academic medicine becoming dependent on research money from such firms for such research.

We previously summarized the case’s events

  • Dr Aubrey Blumsohn, a senior lecturer at Sheffield University, and Professor Richard Eastell performed a research project on the effects of the drug risedronate (Actonel, made by Procter & Gamble Pharmaceuticals [P&G]) under a contract between P&G and the University.
  • Although the research contract designated Blumsohn and Eastell as “Investigators” under whose direction the project would be carried out, Blumsohn was not given access to the original data collected by the project.
  • Despite numerous requests, (like this one), P&G refused access to this data repeatedly.
    Blumsohn was concerned that he and Eastell could be accused of scientific fraud if they continued to make presentations and write articles and abstracts without access to the data which they were supposedly writing about.
  • Blumsohn became suspicious that some of the analyses done by P&G could be misleading, especially related to a graph shown to him that omitted 40% of patient data.
  • Blumsohn objected to P&G arranging for papers and abstracts to be written by a professional writer, but with Blumsohn listed as first author. Blumsohn was concerned that such ghost-written documents were mainly meant to convey “key messages” in support of P&G’s commercial interests.
  • Eastell warned Blumsohn not to aggravate P&G, because the company was providing a grant to the University which “is a good source of income.”
  • After repeated failed attempt to get the data, Blumsohn complained to numerous officials at Sheffield University, including Eastell, medical school Dean Tony Weetman, University Vice-Chancellor Robert Boucher, and the Head of the University’s Department of Human Resources, Ms R Valerio.
  • Still unable to get the data, he spoke with news reporters about his case. At this point, Sheffield suspended him, but then offered him a severance agreement if he signed a contract binding him not to make any detrimental or derogatory statements about the University and its leaders.

So the case involved suppression and manipulation of research, ghost-writing, institutional conflicts of interest, and attempts to silence a whistle blower. It provides lessons about the downsides of letting commercial firms sponsor and hence control human research designed to evaluate the products or services they sell; and of academic medicine becoming dependent on research money from such firms for such research.

Although this case occurred in the UK, it involved actions by the US based Procter and Gamble.  While many of the events in the case occurred before 2004, from 2004 to 2009 it became clear that Procter and Gamble was not going to go easy on Dr Blumsohn.  For example, according to Dr Blumsohn, in 2006, P&G released some scientific data relevant to the case, but not complete enough data to be meaningful.  In 2007, there was still shady business going on involving scientific abstract submissions apparently made in Dr Blumsohn’s name by P&G operatives.

Since Procter and Gamble never made any known attempt to apologize, explain its conduct, or ameliorate Dr Blumsohn’s plight during 2004 – 2009, as one of the most senior leaders of Procter and Gamble, seemingly with direct authority over its pharmaceutical operations in the UK during that time period, Mr McDonald ought to be held accountable for the company’s misbehavior described above.  To my knowledge, though, no one at P&G, including Mr McDonald, has ever admitted responsibility or been made accountable in any way.  


Since Mr McDonald recently was an executive of a company that sold prescription and non-prescription pharmaceuticals, and provided direct health care, confirmation as Veterans Affairs secretary could be regarded as a transit through the revolving door, and hence open to question.  Since Mr McDonald got $15,928,015 in total compensation during his last year as CEO (2012-13) (see the company’s 2013 proxy statement), and had accumulated 2,247,593 shares of stock or equivalent by 2013, worth approximately $179 million at today’s price of $79.67, his ability to understand the needs of the often poor veterans whom the VA serves is also open to question. 

More importantly, while Mr McDonald held high executive positions at Procter and Gamble, the company was involved in a dodgy affair involving conflicts of interest, manipulation of research, and attempted silencing of whistle blowers.  In my humble opinion, given that these events occurred directly on his watch, his fitness to run a huge health care system ought to be in question unless his responsibility for these events is disproved. 

The widespread huzzahs for Mr McDonald as potential VA leader based mainly on his exalted status as CEO of a big corporation show that many in the US still see corporate CEOs as aristocracy.  True health care reform would hold health care leaders accountable, particularly for upholding the health care mission and putting patients’ and the public’s health ahead of revenue generation and especially personal profit. 

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About Lambert Strether

Readers, I have had a correspondent characterize my views as realistic cynical. Let me briefly explain them. I believe in universal programs that provide concrete material benefits, especially to the working class. Medicare for All is the prime example, but tuition-free college and a Post Office Bank also fall under this heading. So do a Jobs Guarantee and a Debt Jubilee. Clearly, neither liberal Democrats nor conservative Republicans can deliver on such programs, because the two are different flavors of neoliberalism (“Because markets”). I don’t much care about the “ism” that delivers the benefits, although whichever one does have to put common humanity first, as opposed to markets. Could be a second FDR saving capitalism, democratic socialism leashing and collaring it, or communism razing it. I don’t much care, as long as the benefits are delivered. To me, the key issue — and this is why Medicare for All is always first with me — is the tens of thousands of excess “deaths from despair,” as described by the Case-Deaton study, and other recent studies. That enormous body count makes Medicare for All, at the very least, a moral and strategic imperative. And that level of suffering and organic damage makes the concerns of identity politics — even the worthy fight to help the refugees Bush, Obama, and Clinton’s wars created — bright shiny objects by comparison. Hence my frustration with the news flow — currently in my view the swirling intersection of two, separate Shock Doctrine campaigns, one by the Administration, and the other by out-of-power liberals and their allies in the State and in the press — a news flow that constantly forces me to focus on matters that I regard as of secondary importance to the excess deaths. What kind of political economy is it that halts or even reverses the increases in life expectancy that civilized societies have achieved? I am also very hopeful that the continuing destruction of both party establishments will open the space for voices supporting programs similar to those I have listed; let’s call such voices “the left.” Volatility creates opportunity, especially if the Democrat establishment, which puts markets first and opposes all such programs, isn’t allowed to get back into the saddle. Eyes on the prize! I love the tactical level, and secretly love even the horse race, since I’ve been blogging about it daily for fourteen years, but everything I write has this perspective at the back of it.


  1. John

    I see a few veteran’s associations (ie MOAA) broadly approve of his nomination.

    It is hard to see how he is going to fix the VA, regardless of his shady past dealings. The VA has a battalion of gatekeepers to slow or in some cases keep veterans from getting service. VA lawyers study every word of the law to see where they can re-interpret Congresses intent and screw veterans. Every VA program is set up this way.

    1. DakotabornKansan

      Harry Truman’s contemplation of General Eisenhower winning the Presidential election: “He’ll sit here, and he’ll say, ‘Do this! Do that!’ And nothing will happen. Poor Ike—it won’t be a bit like the Army. He’ll find it very frustrating.”

      Likewise, private sector leader, CEO of Procter and Gamble, Robert A McDonald will sit there, and he’ll say, ‘Do this! Do that!’ And nothing much will happen. It won’t be at all like being the CEO at P&G.

      By pretending to get rid of corruption, he will only humiliate honest people and provide an even darker cover for malfeasance. This will comfort the powers that be that he is “dealing” with it. They know a man who can reduce any color to grey.

      “Elite power is naturally attracted to a power hierarchy and fits itself neatly, obediently into the one that promises the most personal benefits. Here is the Achilles’ heel of armies, police and bureaucracies.” ― Frank Herbert, The White Plague

      1. NotTimothyGeithner

        Shinseki used that excuse and the veneer of a party switch in power, but this officially a bipartisan scandal caused by the same bipartisan conflicts*. Congress is very worried especially with so many veterans running around who might challenge them. Congress won’t improve the system (there are enough facilities or medical personal without making non-VA health care worse in the short term), but they won’t let Macdonald off because he is new. That already happened to Shinseki who by and large had all of Congress demanding he be fired despite Obama protecting his guy.

        *The best way to help veterans is to stop making them.

  2. trish

    hilarious that anyone would call his appt unorthodox. nothing new here- this has been the trend. Corporate exec to the rescue! within government and without (ie colleges, universities).

    The super-duper fixers of our failing government entities, business-model saviors swooping in to instill their super smart sane & rational streamlined efficient no-nonsense make-things-work business practices, show those fuzzy inefficient and wasteful bureaucrats how to run a business! They’ll fix what’s broke.

    What a ruse.

    1. NotTimothyGeithner

      The silver lining is the VA is a disaster with people expecting results he won’t be able to produce using traditional business practices. Shinseki’s time was ignored because of the sheen of Obama, but the veterans themselves will demand change. Politicians use veterans as props. Even if they are incapable of actually providing the necessary resources, the Congress will hound Macdonald to preserve their props. They are afraid of vets coming out against them.

      His failings will be high profile, and it’s likely the disconnect between the elite and problems will be further exposed. A real reformer would have no chance to fix problems because the VA wasn’t designed to handle the numbers of mental and physical problems created by our current life saving abilities for soldiers who traditionally would have died. The department lacks the facilities and personal to serve the demand, and corruption and mismanagement aside, there isn’t a solution of management capable of fixing this problem.

      At least, it should b e good theater which will come back to the inadequacies of ACA which also suffers from ignoring shortages and an unnaturally unhealthy population. Putting corn syrup in everything creates long term health problems.

      1. Cynthia

        Lengthy waiting lists and increasing costs at VA facilities are a direct result of an interventionist US foreign policy. While US leaders continue to generate new patients in a quest for global supremacy (and corporate profits), waiting lists and costs will continue to increase.

  3. mellon

    We need a one term term limit on Presidents and two terms for Senators and Congressmen. Neither Bohner or Obama should be there making these bad decisions. Corruption occurs quickly and its tied to re-election campaigns so we need to get rid of re-elections.

    1. Lambert Strether Post author

      I disagree. At least in Maine, term limits had the effect of nuking institutional memory for the legislators, meaning the only remaining memory was the lobbyists (and small bands of outgunned activists). Whatever the solution, it’s not term limits.

      1. NotTimothyGeithner

        Abolish the Senate and Presidency, but I would settle for indirect election of Senators. I think it would elevate former state speakers-types who won’t be President and have done hard work as opposed to trendy candidates who think they need to be inoffensive for a run at the President. Winning state gives these people the idea they can be President. Instead of becoming an obstacle to progress, I think they would be too tired or not connected to D.C. to care. Imagine a world without Evan Bayh, and I think this kind of change would get people to care about local government

        Even now, I think the lack of a Democratic message can be traced to all these Senators being under the impression they can get on the ticket but they can’t offend Obama or Hillary. There is another good point. Hillary would have just been a nameless Congressman instead of a high profile Senator.

        I also want to abolish the states and introduce smaller state-level governments similar to Congressional districts but not aligned with Congressional districts with exceptional bodies for New York City, the Chesapeake Bay area, etc.

  4. steelhead23

    I note that in large measure the VA scandal involves exposed subterfuge – hiding the fact that many vets had experienced long delays in getting service. Perhaps Mr. McDonald’s job isn’t so much ensuring that vets get timely and effective care, but in providing better cover for not doing so. In Washington, those two objectives are indistinguishable. Clearly, Mr. McDonald has the skill set for the latter.

  5. Dermot Gilley

    Looking at US corporate culture it seems that it has just gotten difficult to find anyone 8who would be capable of running a large government organization and not just only a corner store) who has not already been tainted by some kind of scandal. So, while they should certainly all be held accountable, don’t expect those with allegedly “clean sheets” actually be less involved in shady dealings- they may just never have been found out. Maybe what could be worse: those who were never able to get involved in scandal due to lack of opportunity and which might now just be promoted to a position giving them that opportunity. I don’t think we can win until a complete overhaul of society has taken place.

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