By Daniel Stone, M.D.
The Health Care Blog, Jan. 29, 2025
As a doctor, I consider Secretary Xavier Becerra and his Department of Health and Human Services (HHS) to be allies of practitioners like me. The behemoth federal agency administers Medicare and Medicaid, the Food and Drug Administration, and an army of public health workers. The Surgeon General, symbolic leader of the nationās healthcare providers, reports to HHS. For decades, the Department has supported medical science in safeguarding the publicās health. Now that sacred trust faces the threat of Donald Trumpās nomination of Robert F. Kennedy Jr. to run HHS.
RFKās first problem is a stunning lack of qualifications. After a laudable triumph over drug addiction, he used his legal background to work on environmental protection. Kennedy never held a federal government position nor administered any public agency. He now appears poised for on-the-job training at an agency with 80,000 employees and a $1.7 Trillion budget. In contrast, Becerra served for years in Congress and on its Health Sub-Committee. He also served as State Attorney General, managing 4,800 employees. The qualification issue is not political. During Trumpās first term, his last HHS secretary, Alex Azar, had served as HHS general counsel and president of pharmaceutical giant Eli Lilly. RFK has nothing remotely resembling his would-be predecessorsā qualifications.
Unfortunately, RFKās shortcomings go well beyond mere lack of qualification. His distortions and public denials of established medical science infuriate practitioners like me. He casts baseless doubt on the well-established benefits of vaccines and on theĀ polio vaccine in particular. Despite the seven decades since polio vaccineās introduction, doctors still see patients who were infected before it was available. My patient Donna, born in 1955, counts herself among this group. She wears leg braces and often struggles with daily activities. For me, she symbolizes those who by accident of birth or happenstance missed the profound benefits of vaccines that RFK now disparages.
RFK also opposes fluoridation of water. Another patient, Judith, age 80, scoffs at such skepticism. She grew up in Niagara Falls, NY, before fluoridation and its dental protection. She remembers her childhood dentist finding 13 cavities and the trauma and pain of prolonged dental work at an early age.
Primary care doctors like me spend our professional lives working to prevent life limiting and life-threatening conditions like those affecting Donna and Judith. We struggle with the challenges of insurance denials, clunky electronic records, healthcare bureaucracy and ballooning patient loads. We donāt need an HHS administrator opposing our efforts to provide standard preventive care. And if RFKās judgment on vaccines is so poor, who can trust him on other critical healthcare issues like pandemic management or drug authorizations?
How should physicians respond? I recently exchanged messages with a politically diverse group of local medical leaders. They all opposed RFK but disagreed on tactics. Some said that the American Medical Association leadership believes RFK to be headed for confirmation. They fear that failed opposition might jeopardize RFKās support on Medicaid and Medicare reimbursements.
The local doctorsā reasoning reflects the same transactional āwhatās in it for meā approach that led to RFKās nomination. RFK mortgaged a share of the Kennedy legacy to help Trump win the Presidency. Now Trump is returning the favor with a cabinet position despite RFKās lack of qualifications and practitionersā opposition. Should organized medicine really adopt the same āwhatās in it for usā approach?
I told my colleagues that I can accept being on the losing side. Despite my efforts, my patients sometimes get sick and even die. But I donāt quit on them or ask, āwhatās in it for me?ā So I will not shrug my shoulders as those representing Americaās doctors swallow RFKās nomination like a dose of castor oil. The senators voting on RFK have their own doctors and medical societies in their home states. Those doctors must explain to their senators why RFK is unacceptable to those on healthcareās front lines.
I have belonged to the California Medical Association for more than 20 years and to the American College of Physicians, the nationās largest medical trade association, for over 30. Although proud of those associations, I will resign from both if they fail to issue strong, evidence-based statements explaining why the RFK nomination is unacceptable. I hope my colleagues do likewise.
As physicians, we take an oath to do no harm. Sometimes doing nothing causes harm. It is time for organized medicine to do the right thing and fight the RFK nomination.
Dr. Daniel Stone is Regional Medical Director of Cedars-Sinai Valley Network, a practicing internist and geriatrician with Cedars Sinai Medical Group, and a member of Physicians for a National Health Program. The views expressed in this column do not necessarily reflect those of Cedars-Sinai.
