NYC's Top Doc on Bloomberg's Aggressive and Often Controversial Health Mandates

Dr. Eric J. Topol Questions Dr. Thomas Farley on His Provocative Approach to Population Health

; Thomas Farley, MD, MPH

Disclosures

December 18, 2013

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In This Article

Editor's Note:
As New York City Mayor Michael Bloomberg prepares to leave office, his health commissioner, Thomas Farley, MD, MPH, speaks with Medscape Editor-in-Chief Eric J. Topol, MD, about the aggressive and often controversial efforts of the administration to mandate healthy lifestyles in the nation's largest city. From smoking and trans fat bans to posting calories on menus and asking hospitals to "hide" formula from new moms in an effort to encourage breastfeeding, New York City's health policies under Mayor Bloomberg, implemented by Dr. Farley, have been both applauded and condemned. Recent efforts to ban sodas and sugary drinks larger than 16 ounces, and mandating flu shots for children age 5 and under, have resulted in lawsuits and protests.

Still, research shows that at least some of the Department of Health and Mental Hygiene's health policies have proven successful.[1] In this interview, Drs. Topol and Farley debate the pros and cons of focusing on population vs individual health.

New Orleans to New York City

Eric J. Topol, MD: Hello. I'm Dr. Eric Topol, Editor-in-Chief of Medscape. Joining me today for Medscape One-on-One is New York City Health Commissioner Thomas Farley.

Thomas Farley, MD, MPH: Good morning.

Dr. Topol: I wanted to get started with a little bit of background. You were raised in New Jersey; is that right?

Dr. Farley: Right.

Dr. Topol: But you somehow wound up at Tulane in New Orleans. How did that happen?

Dr. Farley: I went to Tulane for medical school. I met my wife [in New Jersey], but we got married when we were [in Louisiana]. She's from south Louisiana, so when we had the opportunity to live anywhere, she wanted to go back to the area where she was raised. So I lived in New Orleans for 24 years and raised my family there. It's a great place to live, but later I had an opportunity to come back up here to New York and couldn't miss that.

Dr. Topol: You trained in pediatrics and also have a master's degree in public health, correct?

Dr. Farley: I'm trained in pediatrics but didn't work much as a practicing pediatrician. I went into public health through the Centers for Disease Control and Prevention (CDC) Epidemic Intelligence Service and later went back and got a master's in public health and epidemiology. I've been working in public health pretty much my whole career.

Dr. Topol: You spent a year in Haiti; is that right?

Dr. Farley: I spent a year in Haiti working on a community health project up in the mountains in a rural area. I worked really hard. I would say it was mostly a failure, though, and I learned a little bit about the difficulties of putting in place public health projects at the community level in an area where the politics are difficult, to be honest.

Healthy Lifestyle

Dr. Topol: I know you are really into a healthy lifestyle. Do you exercise every day?

Dr. Farley: I'm an exerciser. I'm a runner. I've been doing that for years.

Dr. Topol: Did you already have a workout today?

Dr. Farley: I did, yes.

Dr. Topol: What was your workout?

Dr. Farley: Today I went to the gym, worked on the treadmill a little bit, and lifted some weights. I'm hoping to run the New York City Marathon, so today was kind of a light day for me in my taper phase.

Dr. Topol: That's a daily routine? You don't miss a day?

Dr. Farley: Seven days a week; I don't feel right if I don't get some form of exercise. I'm kind of addicted to it at this point.

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