These alarming changes show how Trump is wrecking public health
As a family physician, I work every day to earn the trust of my patients. I see lines being blurred between politics and medicine and, despite the high trust the public has in their own physician, it is becoming harder to separate medical and scientific information from misinformation.
I hear this concern from my patients, particularly when trusted resources, like the Centers for Disease Control and Prevention (CDC), make drastic policy shifts: Is this science based decision-making or politics?
Who do you trust?
With every new patient I see, I share my approach to care by saying, “I work for you. In many ways, you are my boss. My job is the make assessments and recommendations, yours is to make decisions, and I’m here to help you with that. How does that sound to you?”
People universally embrace this approach. It promotes individual autonomy and shifts the power to the patient — where it belongs. National surveys reveal that trust in government agencies such as the CDC is at an all time low, on par with approval ratings for Congress. However, trust in one’s own personal physician remains very high, with nearly eight in 10 people rating their personal doctors as “very good” or “excellent,” according to a recent People’s Voices Survey.
Despite this relatively high trust the public has in their own doctors, the insertion of politics into the exam room has made it harder for people to make the right decisions for themselves by infecting the relationship between people and their doctors with misinformation, causing people to second guess recommendations they are receiving.
Pull back the curtain
The public has good reason to be suspicious of the CDC right now. The changes approved last week by the CDC’s Advisory Committee on Immunization Practices, or ACIP, are arbitrary, not science-based, and go against decades of safety and efficacy data. Their vote to remove hepatitis B vaccination from the recommended infant and child schedule will lead to a resurgence of hepatitis B.
Prior to recommending newborn vaccination in 1991, 18,000 children were diagnosed annually with hep B, a chronic illness that leads to liver failure and liver cancer.
Half of these children were infected through mother-to-child transmission, and giving the shot at birth prevents the virus from taking hold.
The other half occurred through contact with saliva or blood exposure to someone else who is infected. The virus can stay active for up to a week on surfaces and is known to have been transmitted during sports and in child care settings, through coming in contact with the virus by touching a contaminated surface, or exposure to scrapes or bites. (Up to half of the children in child care are bitten by another child each year.)
Since vaccination was universally recommended, infection rates have dropped by nearly 99 percent, and today we see much less liver failure and cancer resulting from hepatitis B infection. No one wants to see those numbers increase again.
What are physicians saying?
Making ACIP a political committee rather than one based on science means that recommendations are subject to bias and can no longer be trusted. This breach of trust by our government results in lack of confidence in vaccine recommendations across the board, including those by the public’s trusted health care professionals who they continue to see as excellent.
Because politics and politicians are interfering with the patient-doctor relationships and undermining trust in public health measures like vaccines, we will likely see infections rise as we have seen with measles this past year.
While the federal government is spreading misinformation through ACIP and the CDC, the state of New Hampshire is showing that it still trusts doctors over politics with regard to childhood vaccines, directing New Hampshire doctors to adhere to vaccine recommendations from the American Academy of Pediatrics and the American Academy of Family Physicians.
As I stated earlier, I work every day to earn the trust of my patients and to share the best medical information and highest-quality patient care available. I keep politics out of the exam room, and we need the politicians to stay out of our exam rooms and our relationships with our patients.
When going to see your doctor, remember that we work for you and our recommendations are based on years of training, a dedication to science, and, most importantly, a commitment to partnering with you to make the best decisions for your health.
- P. Travis Harker, MD, MPH is a family physician in Portsmouth and a past president of the New Hampshire Medical Society.
