Dr. Marty Makary on Rebuilding Trust in Medicine and Reforming the FDA | 13th and Park
What this video covers
In this February 2026 episode of the Ballard Partners-produced “13th and Park” podcast, hosts Adam Goodman and Alison interview then-FDA Commissioner Marty Makary about rebuilding public trust in medicine and reforming the agency. (Makary resigned as commissioner on May 12, 2026.)
Makary outlines what he describes as 42 major FDA reforms undertaken in his first 10 months — including national priority review vouchers designed to speed breakthrough treatments, shorter review times, and greater transparency. He explains why he favors Bayesian clinical trial designs and how he says the agency is closing food-chemical loopholes.
The conversation ranges beyond drugs: the microbiome, antibiotic overuse, hormone replacement therapy, reshoring pharmaceutical supply chains, over-the-counter drug reform, and what Makary calls getting “back to science” in an era of declining institutional trust. On the microbiome, he cites a study finding higher colon cancer rates in people born by C-section, says the average two-year-old has taken about 2.5 courses of antibiotics, and claims 90% of the body’s serotonin is made in the gut lining — points he uses to argue gut health has been ignored by medical education. He traces the modern peanut-allergy epidemic to the American Academy of Pediatrics’ advice to avoid peanuts until age three, which he says got it backwards by preventing oral immune tolerance. He also says the FDA is onboarding roughly 1,000 new scientists, arguing that in the past 19 of 20 leadership openings went to internal candidates.
The framing is notably institutionalist for a figure who built his public profile criticizing the medical establishment — here he speaks as the establishment’s reformer, arguing the FDA itself can be the vehicle for restoring confidence.
Key points
- Makary claims 42 major FDA reforms in his first 10 months, including faster reviews and more transparency.
- He promotes national priority review vouchers to accelerate breakthrough treatments.
- He advocates Bayesian trial designs and closing food-chemical regulatory loopholes.
- He discusses the microbiome, antibiotic overuse, and hormone replacement therapy as under-addressed areas.
- He frames reshoring drug manufacturing and over-the-counter drug reform as trust-restoring measures.
- His core pitch: the FDA can lead a return to science-driven, transparent regulation.