Angell joined the editorial staff of The New England Journal of Medicine in 1979. She became Executive Editor in 1988, and served as interim Editor-in-Chief from 1999 until June 2000. The NEJM is the oldest continuously published medical journal, and one of the most prestigious; Angell is the first woman to have served as Editor-in-Chief of the journal since it was founded in 1812. In 1999, Jerome P. Kassirer, M.D. resigned as NEJM's Editor-in-Chief following a dispute with the journal's publisher, the Massachusetts Medical Society, over the Society's plan to use the journal's name to brand and market other sources of healthcare information. Angell agreed to serve as interim Editor-in-Chief until a permanent editor would be chosen. She reached an agreement with the society that the Editor-in-Chief would have authority over usage of the journal's name and logo, and that the journal's name would not be used on other products. Angell was a finalist for the permanent post of Editor-in-Chief, but withdrew as a candidate explaining she was retiring to write a book on alternative medicine. Angell retired from the journal in June 2000 and was replaced by Jeffrey Drazen, M.D.
Commenting on the 1992 Prescription Drug User Fee Act which allowed the Food and Drug Administration to collect fees from drug manufacturers to fund the new drug approval process, Angell has stated :
Critic of U.S. healthcare system
Angell has long been a critic of the U.S. healthcare system. The American healthcare system is in serious crisis, she stated in a 2000 PBS special: "If we had set out to design the worst system that we could imagine, we couldn't have imagined one as bad as we have." In the PBS interview, she urges the nation to scrap its failing healthcare system and start over:
Angell is a critic of the pharmaceutical industry. With Arnold S. Relman, she argues, "The few drugs that are truly innovative have usually been based on taxpayer-supported research done in nonprofit academic medical centers or at the National Institutes of Health. In fact, many drugs now sold by drug companies were licensed to them by academic medical centers or small biotechnology companies." The pharmaceutical industry estimates that each new drug costs them $800 million to develop and bring to market, but Angell and Relman estimate the cost to them is actually closer to $100 million. Angell is the author of The Truth About the Drug Companies: How They Deceive Us and What to Do About It. In her 2004 article "The Truth About the Drug Companies", published in The New York Review of Books, Angell wrote : Richard Friedman, director of the psychopharmacology clinic at Weill Cornell Medical College, and a regular contributor to the New York Times science pages, criticized Angell's views as unbalanced. "Dr. Angell is now doing pretty much the same thing the industry she assails has done, just the converse. Pharma withheld the bad news about its drugs and touted the positive results; Dr. Angell ignores positive data that conflicts with her cherished theory and reports the negative results.”
Thoughts on alternative medicine
Marcia Angell is also a critic of the current categorization of alternative medicine. In a 1998 NEJM editorial she wrote with Jerome Kassirer, they argued:
Awards and honors
In 1997, Time magazine named Marcia Angell one of the 25 most influential Americans for that year.