The recent cancellation of the July meeting of the U.S. Preventive Services Task Force (USPSTF) by the secretary of Health and Human Services has alarmed many clinicians in the primary care workforce. Clinicians across the country are deeply concerned about what this potentially could mean for the delivery of cancer and chronic disease screenings and counseling, as well as the use of critically important preventive medications, all of which improve the health of our patients, and ultimately, of people across the nation.
Created in 1984, the USPSTF is a scientifically independent, volunteer panel of national experts in prevention and evidence-based medicine that issues and updates care recommendations on over 90 different topics to help our patients live longer and healthier lives. There is no debate that timely and accurate use of preventive services, such as mammograms or counseling for physical activity, keeps people healthy and saves lives. But getting those services to the right people at the right time in life is logistically complex. This is where the USPSTF recommendations come in as critical tools that make the delivery of high-quality prevention possible.
Primary care doctors and other clinicians across the nation trust and use the USPSTF recommendations virtually every day when they care for patients.
The trustworthiness of the USPSTF is grounded in how members are nominated, evaluated, and appointed, in addition to the rigorous, reproducible methods employed to develop its recommendations. Task Force members are trusted because they all undergo extensive vetting for conflicts of interest and are unpaid volunteers who do not have a financial or professional stake in the content of their recommendations. Members serve a 4-year term with approximately 25% rotating off each year; this structure is critically important for continuous infusion of new members while also preserving USPSTF institutional knowledge. The recommendations themselves are trusted because they are developed through transparent methods that are available online for anyone to review. Given the rapid proliferation of un-curated, questionable information on the internet and across social media, there never has been a more important time to have readily available trustworthy recommendations available at no cost to clinicians and their patients.
Our gravest concern is that the processes in place to ensure the USPSTF and its recommendations are trustworthy will be changed at this critical time.
Healthcare professionals and the public alike need to know that the vast majority of task force members are also primary care clinicians who use the USPSTF recommendations almost every time we see our patients. We witness firsthand the relief of our patients and their families when we find a breast or colon cancer when it is small and can reassure them that it has a high likelihood of being cured. Our nation deserves a healthcare delivery system where we can routinely prevent serious conditions or offer patients screening opportunities to catch and treat diseases as early as possible. As primary care clinicians, it is impossible to imagine practicing without up-to-date, evidence-based, trustworthy USPSTF recommendations at our fingertips.
The loss of trustworthiness in the rigorous and nonpartisan work of the task force would harm patients, hospital systems, and payers, as misinformation creates barriers to accessing lifesaving preventive services. Although the July meeting is cancelled, we do not yet know what is in store for the task force. What we do know is that it is vital that the task force is preserved — the lives of people across the country depend on it.
Carol M. Mangione, MD, MSPH, is the chief of the Division of General Internal Medicine and Health Services Research and the Barbara A. Levey, MD, and Gerald S. Levey, MD, endowed chair in medicine at the David Geffen School of Medicine at the University of California, Los Angeles (UCLA). Karina W. Davidson, PhD, MASc, is dean of academic affairs at the Feinstein Institutes for Medical Research, senior vice president of research at Northwell Health, and the Donald and Barbara Zucker Endowed Professor in Health Outcomes in the Department of Medicine at Zucker School of Medicine at Hofstra University. Douglas K. Owens, MD, MS, is the Henry J. Kaiser, Jr. Professor, chair of the Department of Health Policy in the Stanford University School of Medicine, and director of the Center for Health Policy (CHP) in the Freeman Spogli Institute for International Studies. Mangione, Davidson, and Owens are all past chairs of USPSTF.
The views expressed are solely those of Mangione, Davidson, and Owens and do not represent the institutions where they work or those of the U.S. Preventive Services Task Force.
