President-elect Donald Trump has nominated Robert F. Kennedy Jr. as secretary of Health and Human Services, and six leaders joined Becker's to discuss what this could mean for physicians.
Question: What does President-elect Donald Trump's nomination of RFK Jr. as secretary of Health and Human Services mean for physicians?
Jason Acevedo, MD. Otolaryngologist and President-Elect of West Texas Health (Abilene): I think that there are mixed emotions in the physician community. Some are very excited about the prospect of a healthier food chain and more nutritious options for Americans. At the same time, many are concerned about his positions on vaccines and are worried that vaccine hesitancy could lead to the resurgence of diseases that have been nearly eliminated. I think we all hope that whatever policies he enacts (if he is confirmed) will be evidence-based and vetted by the medical community.
Thomas Asfeldt. President of Leadership Advisory Firm The Twelve7 (Sioux Falls, S.D.): First of all, everyone's response should be led with we don't really know, but we might have some informed opinion based on broad comments related to healthcare made by both President-elect Trump and appointee RFK Jr.
President Trump has a history of deregulating industries and RFK Jr. has stated that regulations have created a barrier for physicians to focus on patient-centered care. Both have commented that deregulating healthcare needs to happen. Therefore, it would seem likely that there will be significant movement to eliminate regulations that do not directly contribute to patient outcomes and strengthen the physician/patient relationship. From RFK Jr.'s many comments surrounding chronic diseases and wellness, one can assume there will be a particular focus surrounding primary care and prevention.
RFK Jr.'s comments about the need to return decision-making to the physician, while also securing President Trump's goals of eliminating waste and fraud, will be interesting to see unfold. There will be a tension to increase freedom through deregulation while also getting rid of waste and catching fraud. All important goals in an overly costly, relatively low-quality healthcare system. I think it's fair to assume returning decision making to the physician is a direct attack on the prior authorization burden, and physicians should expect significant pressure to decrease prior auth requirements.
RFK Jr. has a dislike for corporate interests, profit, lobbying, etc. over patient interests. Although his comments have focused primarily on the food industry and pharma, his disdain for any institutional or large association interests before the patient is broad, one could assume this would extend to physicians (or any other direct care provider) as well, if interests are self-serving rather than patient serving. As radical change may come to healthcare over 2025-2028, physicians have the opportunity to contribute to a more patient-centered, wellness-focused, effective system.
Steve Ayers, CRNA. Managing Partner at Anesthesia Associates of Coeur d'Alene (Idaho): As the managing partner of a midsized anesthesia group, I'm not certain how RFK Jr.'s appointment to HHS will affect physicians. But I do know that the CMS cuts for physician services are unsustainable, and reimbursement overall is significantly worse since the passage of the No Surprises Act. Not only is CMS reimbursing anesthesia at rates lower than 2010 (about 4% less and not indexed to inflation), but the NSA has removed any leverage we had with health insurers. Any requests to payers to increase reimbursement are simply ignored. I'm hopeful that RFK Jr. can eliminate some of the waste and fraud inherent in the system and use these savings to reimburse physicians more fairly.
Ivan Mac, MD. Founder of Metrolina Eye Associates (Stallings, N.C.): His appointment as Secretary of HHS will not have much effect on physicians. We are facing a situation where physician reimbursement has been cut to the bone and I doubt whoever is in charge will have much incentive to make a change to the long-term trajectory of reimbursement in this country. The elected representatives and unelected bureaucrats really have no incentive to make changes that affect reimbursement. If there is a wholesale change at CMS, there may be less bureaucracy, but there will also be cuts to Medicaid and other social programs for healthcare to pay for extending the Trump tax cuts. This will likely be a net negative for physicians. As for public health as a whole, that is a real wild-card. Public health will suffer if there is increased vaccine hesitancy, but could also improve if there is a focus on promoting healthy changes in the food supply to cut additives and processed foods.
Moez Mithani, MD. Anesthesiologist and Owner of Atlas Spine and Pain Management (New Brunswick, N.J.): President-elect Donald Trump's appointment of RFK Jr. as Secretary of Health and Human Services is very alarming news. RFK Jr. has publicly denied the effectiveness and safety profiles of vaccines, against the overwhelming consensus of the scientific and medical community. He poses a very material threat to the safety and well-being of the American public and would be catastrophic to advancing medical science in the coming administration.
Moreover, RFK Jr. has made it clear that he does not intend to follow evidence-based medicine or utilize physician experts in implementing health policy and measures, which is extremely concerning. The president-elect has an opportunity to make some beneficial healthcare changes, but his appointment of RFK Jr. as the Secretary of Health and Human Services is a step in the wrong direction.
James Torosis, MD. Gastroenterologist at Peninsula Gastroenterology Medical Group (Redwood City, Calif.): As physicians, we have always used science and evidence-based medicine in order to make sound medical recommendations for our patients. Having RFK Jr. as secretary of HHS goes completely against the grain of mainstream medicine. It is not only an embarrassment for the government and American people, it is also outright dangerous. He potentially can derail all the institutions and safeguards we rely on for medical decision-making such as the CDC and FDA. We also do not know how he will handle Medicare and Medicaid as far as paying for fundamental medical treatments and prevention. In short, his motivation appears to be driven by fame and personal gain rather than putting the health of America first. Very sad.