Will Health Care Suffer If We Say Nothing?

Is Silence Really an Option?

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I know nothing about tariffs and am not qualified to write a political blog. But I have participated in the care of an unvaccinated Christian Scientist boy who got polio in 1972, (1) and I have received multiple National Institutes of Health (NIH) grants. I was one of the first eight recipients of the NIH’s Preventive Cardiology Academic Award, a program designed to increase the pool of clinicians interested in preventing heart disease. So, I do know something about medicine and the NIH.

The Journal of the American Medical Association (JAMA) in its April 8th 2025 issue featured a “Viewpoint” entitled “How Should Health Care and Public Health Respond to the New US Administration.” (2) It noted that in its first week in power, our new administration:

- withdrew from the World Health Organization

- withdrew from the Paris Agreement on Climate

- paused publication of the Morbidity and Mortality Weekly Report

- prohibited the Department of Health and Human Services from publishing on outside websites

- removed website material encouraging minority enrollment in clinical trials

- cancelled National Institutes of Health (NIH) study section and advisory board meetings

- reorganized the Centers for Disease Control and Prevention (CDC)

- reorganized the Food and Drug Administration

And more has happened since that first week, including the appointment of an anti-vaxxer to head the Department of Health and Human Services, and the deportation of a physician because of her political views.(3)

I am concerned that these changes do not help our patients because they:

- reduce our involvement in international health when the next epidemic is a plane ride away

- allow our air to be polluted and our planet to warm

- restrict information on health trends in our country and the world

- block the distribution of scientific information and opinion

- avoid learning how different types of patients respond to the same treatment

- reduce NIH activity and funding when so much has come out of NIH-funded research. (Remember, we never know where research will lead - Alexander Fleming was not looking for penicillin when he found it in 1928.)

- “fix” the CDC and FDA when they seemed to be doing a great job

The JAMA Viewpoint ends with the statement that “Silence is not an option.”

Well, silence is an option if you think that these changes are good for people and patients, or if you think we should allow this to happen and evaluate the results. I have colleagues whom I respect who believe the latter, and I do not want to offend or alienate them. But I worry that dismantling these institutions will take at least a decade to fix, and that we will wind up not leading the world in medical research, but trying to catch up.

I have written letters to all Republican Senators respectfully expressing my concern. No matter what side you are on, I urge you to express your opinion.

There is the parable of a hummingbird that was trying to protect its nest from a forest fire. It would fly to a stream, pick up a drop of water and deposit it on its nest. An elephant saw this and ask the bird what it was doing. The bird replied, “What I can.”

You might find it interesting that when I signed the letters to the Senators, I did not include my title because I did not want to imply that my former institutions had anything to do with my opinion. Similarly, some friends who pre-read this post feared that I would face retribution. The fact that anyone felt I needed to be careful about expressing my thoughts in America is astonishing. That and a hummingbird convinced me that it was my duty to post this piece.

1. https://www.nytimes.com/1972/10/26/archives/12-pupils-are-stricken-by-polio-at-private-school-in-greenwich.html

2. Woolf SH.How Should Health Care and Public Health Respond to the New US Administration? .JAMA. 2025 Apr 8;333(14):1197-1198. PMID: 39888609

3. https://en.wikipedia.org/wiki/Deportation_of_Rasha_Alawieh

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