Physician expertise, advocacy, and the decline of the USPSTF

My Sensible Medicine articles are, roughly, of two types. The first are a bit self-important; I think I know what I am talking about, and I want to let other people know. The second, I write when I am not quite sure about something. The writing allows me to try out an opinion. Sometimes these essays never see the light of day. Sometimes, I post them, read the comments, and my opinion either evolves, matures, or is abandoned.

This essay is of the latter type. I’m not sure I believe what I am writing, and I am not sure my reasoning holds up.

Physicians are duty-bound to advocate for their patients. In fact, a doctor who does not tirelessly work for her patients does not deserve to be called a doctor. On the other hand, I do not think that physicians have a duty to be public advocates; they may choose to advocate publicly, but they are not duty-bound. Recently, doctors have increasingly become public and political advocates. The history of the United States Preventive Services Task Force teaches us about the risk of physicians becoming public advocates. The USPSTF lost its dedication to strictly evidence-based recommendations when they were assigned an advocacy role by the Affordable Care Act.