AMA ‘deeply concerned’ that RFK Jr. could fire USPSTF members

Members of the U.S. Preventive Services Task Force (USPSTF) should continue their independent analyses and recommendations about health care services that stop illnesses before they start in patients, according to the American Medical Association (AMA).

The physician group released a statement saying its leadership and members are “deeply concerned” about reports of a shake-up coming to USPSTF. The Wall Street Journal reported Health and Human Services (HHS) Secretary Robert F. Kennedy, Jr., plans to fire the 16 members “because he views them as too ‘woke,’” according to “people familiar with the matter.” An HHS spokesman told CNN as of July 25, there was no final decision on USPSTF members and how they fit into HHS’ mandate to Make America Healthy Again.”

Keeping patients healthy

Even so, AMA published its letter to Kennedy based on the news reports. The association highlighted the vital role that USPSTF plays in primary care across the nation.

“The USPSTF has long played an essential role in making evidence-based recommendations for clinical prevention of disease,” the AMA letter said. “USPSTF members have been selected through an open, public nomination process and are nationally recognized experts in primary care, prevention and evidence-based medicine. They serve on a volunteer basis, dedicating their time to help reduce disease and improve the health of all Americans — a mission well-aligned with the Make America Healthy Again initiative.

“Importantly, the USPSTF puts forth recommendations that dictate coverage policy for health insurers nationwide,” the AMA letter said. “By law, insurers must cover USPSTF-recommended services without cost sharing. This means that patients have access to services such as screenings for colon, breast, and lung cancer; screenings for anxiety and depression in children; and screenings and preventive services for cardiovascular disease. Access to these services without cost sharing plays a critical role in keeping patients healthy and reducing the burdens of disease.”

Meeting canceled

USPSTF generally makes news for recommending things that doctors should look for in their patients, or for stating more study is needed on a medical issue in primary care. But the report of a shakeup marked the second time this month the task force landed in the news due to being a potential target for Kennedy.

In early July, the secretary canceled USPSTF’s in-person meeting, without explanation. A coalition of 104 medical and public health groups almost immediately sent a letter to congressional leaders urging them to protect USPSTF’s independence. The groups, including AMA, the American College of Physicians, and the American Academy of Family Physicians, noted safeguards that protect USPSTF’s independence. Along with screening for conflicts of interest, volunteer members stagger their terms, and there is an open nomination process for members. The medical groups stated those practices should remain in place.

The move would not be unprecedented for HHS, where Kennedy began overseeing internal job cuts upon being confirmed to the post. Physician organizations largely panned his decision to fire members of the Advisory Committee on Immunization Practices and replace them with other analysts.

Who are they?

USPSTF operates with a chair, two vice chairs, and a panel of 13 other members. They are “screened to ensure that they have no substantial conflicts of interest that could impair the scientific integrity of the Task Force’s work.” The HHS secretary appoints members to four-year terms. The members are:

• Chair Michael Silverstein, MD, MPH
• Vice Chair John B. Wong, MD, MACP
• Vice Chair Esa M. Davis, MD, MPH
• David Chelmow, MD
• Tumaini Rucker Coker, MD, MBA
• Alicia Fernandez, MD
• Ericka Gibson, MD, MPH
• Carlos Roberto Jaen, MD, PhD, MS, FAAFP
• Marie (Tonette) Krousel-Wood, MD, MSPH
• Sei Lee, MD, MAS
• Goutham Rao, MD, FAHA
• John M. Ruiz, PhD
• James Stevermer, MD, MSPH
• Joel Tsevat, MD, MPH
• Sandra Millon Underwood, RN, PhD
• Sarah Wiehe, MD, MPH

Good medicine

The task force members consider a range of health care topics as varied as primary care itself. The USPSTF website lists its most recent announcements involving final research plans for vision screening in young children and interventions for tobacco cessation in adults. The task force also made a final recommendation on screening for intimate partner violence and abuse of older or vulnerable adults.