As our research team was analyzing the results of our newest federal scientist survey that was released earlier this week, it was heartening to see that at some agencies, like at the U.S. Food & Drug Administration (FDA), the job satisfaction and ability to work appear to be even better than in years past. One of the best characterizations of the sentiments expressed by FDA scientists is this quote from a respondent: “The current administration has overall enforced certain science policies which harm the public in general. However, the current commissioner is fantastic and committed to the FDA’s mission. He is consistently involved in policy development which allows the protection and promotion of public health.”
We sent 9,378 FDA scientists and scientific experts a survey; of which 354 responded, yielding an overall response rate of 3.8 percent. Overall, our findings suggest that scientists at the FDA are faring better than their colleagues at the other 16 federal agencies surveyed. FDA scientists overall appeared to have faith in FDA leadership, including the FDA commissioner Dr. Scott Gottlieb.
So what is FDA doing right?
Commissioner Gottlieb visits the agency’s Center for Devices and Radiological Health (CDRH) in Silver Spring, MD in November 2017 (Photo credit: Flickr/US FDA)
A genuine interest in getting the science right
Encouragingly, and as in previous UCS surveys, FDA scientists called attention to efforts by the agency to protect scientific integrity, with some responses indicating a strong sense of trust in supervisors and leadership. Most FDA scientists reported no change in personal job satisfaction or perception of office effectiveness; some respondents noted increased job satisfaction during the past year. 25 percent (87 respondents) said that the effectiveness of their division or office has increased compared with one year ago. Part of the reason for the agency’s effectiveness is its ability to collect the scientific and monitoring information needed to meet its mission, a metric that has significantly improved between 2015 and 2018. (See figure below). Further, 65 percent (222 respondents) felt that their direct supervisors consistently stand behind scientists who put forth scientifically defensible positions that may be politically contentious.
In 2018, the majority of FDA respondents felt that the agency frequently collected the information needed to meet its mission. When compared with previous results, the most significant differences were found between the 2015 and 2018 surveys (p<0.0001).
Perhaps it is because Gottlieb is a medical doctor who seems genuinely interested in evidence-based policies that we have not been bombarded with policy proposals that sideline science from the FDA since he began leading the agency in July 2017. FDA scientists who took the survey have corroborated this. One respondent wrote that that “the Commissioner’s office is tirelessly upholding best practices in various scientific fields such as smoking cessation, opioid/addiction crisis, generic drug manufacturing, sustainable farming practices.” Another respondent wrote, “FDA has a proactive Commissioner who —so far—has consistently followed science-based information and promoted science-based initiatives in the interest of public health.”
He has encouraged the work of FDA’s advisory committees like the Drug Safety and Risk Management Advisory Committee and the Anesthetic and Analgesic Drug Products Advisory Committee that recently met to make recommendations to the FDA on its regulation of transmucosal immediate-release fentanyl (TIRF) products, which were being prescribed for off-label uses for years. Gottlieb does not get defensive about weak spots in FDA’s portfolio. According to one respondent, “I’ve been pleasantly surprised by Commissioner Gottlieb’s knowledge and focus on FDA science. I was at a brief with him and he was interested in the science and less focused on the legal and political effects than I would have guessed. He was open-minded and curious, and asked questions when he didn’t understand the issue fully. It improved my outlook on my Agency’s future.” The ability for Gottlieb to ask questions and listen to agency scientists as well as outside experts is an important quality for a Commissioner making decisions that impact our health and safety.
I took this photo of an advertisement on a DC metro train this summer, revealing that Gottlieb is serious about recruitment to the agency.
Taking action to improve hiring practices and retention of staff
Soon after Commissioner Gottlieb was confirmed, the FDA took steps to examine its own hiring practices to identify improvements that could be made to build and keep a stronger workforce. The agency wrote a report, held a public meeting, and received feedback from FDA staff throughout the process because according to Gottlieb, “The soul of FDA and our public health mission is our people. Retaining the people who help us achieve our successes is as important as recruiting new colleagues to help us meet our future challenges.” For scientific staff, the agency plans to do more outreach to scientific societies and academic institutions for recruitment and to reach out to early career scientists and make them aware that public service at the FDA is a viable career option.
A commitment to transparency
Not only have there been some encouraging policies put in place by the FDA, but Gottlieb seems committed to informing the public about these decisions. He is very active on twitter and issues so many public statements that reporters feel almost overwhelmed by his updates. This is in contrast of course to leaders like former EPA Administrator Scott Pruitt who seldom announced his whereabouts in advance and was openly hostile to reporters.
Still room for improvement at the FDA and across the government
To be sure, there have been some bumps along the road. Last year, Gottlieb disbanded the FDA’s Food Advisory Committee, which was the only federal advisory committee focused entirely on science-based recommendations on food safety, and he delayed implementation of changes to the nutrition facts label that would have included a line for added sugars by this summer.
Further, survey respondents noted that inappropriate outside influence, such as from regulated industries, is apparent and stymies science-based decisionmaking at the agency. 22 percent (70 respondents) felt that the presence of senior decisionmakers from regulated industries or with financial interest in regulatory outcomes inappropriately influences FDA decisionmaking. Nearly a third (101 respondents) cited the consideration of political interests as a barrier to science-based decisionmaking and 36 percent (114 respondents) felt that the influence of business interests hinders the ability of the agency to make science-based decisions. In addition, respondents reported workforce reductions at the agency and said these lessened their ability to fulfill FDA’s science-based mission.
One thing became very clear as we reviewed the results of UCS’ seventh federal scientist survey that closed this spring: scientists across many federal agencies have been unable to do their jobs to the best of their ability under the Trump administration. Since the start of 2017, agencies have been hollowed out and there has been a sharp decline in expertise and capacity. Reduced staff capacity combined with political interference and the absence of leadership in some cases has made it harder for scientists to carry out important work. As the threat of political influence looms large over the government, much of federal scientists’ ability to do their work to advance the mission of the agencies has to do with the quality of leadership and the administrator or commissioner’s commitment to evidence over politics as a basis for decisionmaking.