Improving the nation’s health requires candid discussion

David O. Barbe, MD, MHA
President
American Medical Association
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As a family physician, it is my duty to discuss unpleasant matters with my patients every day.

These conversations can include discussing whether an elderly family member should no longer drive, telling an obese patient the negative health consequences of carrying too much weight, or delivering the life-changing news of a cancer diagnosis.

When I have such discussions with patients, I can’t sugarcoat my message with euphemisms that disguise the seriousness of the situation. In order to be effective, I need to use straightforward language that my patients will understand and remember. Words matter. They inform how we see the choices that face us, as challenging as they may be.

That is why it is so disturbing to read news reports that Health and Human Services (HHS) agencies such as the Centers for Disease Control and Prevention (CDC) are being advised to avoid using certain words in preparing their budget recommendations.

According to reports in multiple, respected news outlets, certain words or phrases have been listed as no-go territory at HHS agencies. These include “diversity,” “entitlement,” “evidence-based,” “fetus,” “science-based,” “transgender” and “vulnerable.” That last word alone appears in 29 separate AMA policies.

The mission of the CDC is to “fight disease and support communities and citizens to do the same.” By limiting the words that can be dedicated toward this mission, federal spending priorities will be unclear and the effectiveness of the dedicated men and women on the CDC staff would surely be impeded.

The HHS has responded by saying the assertions that it has banned certain words and phrases are a “mischaracterization” of its budget discussions. The AMA, in a letter to Acting HHS Secretary Eric Hargan sent today, has strongly recommended that HHS issue a more detailed clarification of this matter to reassure the public of its devotion to health policy based on evidence and designed to meet the needs of a diverse nation that includes many vulnerable populations.

The CDC and other agencies of HHS need to focus on their vital mission, and they cannot be hindered in their effort to fulfill it. Their work is too important to be muffled.

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Jun 14, 2018
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