Friday, April 29, 2016

Medical officers' labor is essential, but often unheralded

I recently gave a talk on diabetes screening to Preventive Medicine residents at Uniformed Services University of the Health Sciences, where I re-connected with two former residents, now faculty, whom I supervised as a medical officer at the Agency for Healthcare Research and Quality (AHRQ) from 2006 to 2010. A lot has changed in the past six years. The Center for Primary Care, Prevention, and Clinical Partnerships, which housed the U.S. Preventive Services Task Force program, is now known as the Center for Evidence and Practice Improvement, and the role of USPSTF medical officers has been considerably circumscribed. Staff no longer perform in-house systematic reviews such as this one on prostate-specific antigen screening that won me AHRQ's Article of the Year Award in 2009. Individual medical officers are no longer even acknowledged by name in USPSTF documents, which now thank generic "AHRQ staff," I suppose to preemptively distance the agency from any politically controversial recommendations.

This isn't to say that I think the job is no longer worth doing. Indeed, when I found out earlier this year that AHRQ was looking to fill USPSTF medical officer positions, I shared the job description with contacts far and wide. Yes, the role may have changed, even somewhat diminished. Yes, it may never be more trendy to be anti-government (and less trendy to work for the government) than it is today, when an ignorant, unqualified billionaire reality TV star who can't let a day go by without offending another constituency is close to clinching a Presidential nomination. But the work of the Task Force must go on, as it has since 1984. And the engine that drives the Task Force's work is - and always has been - the labor of a group of unheralded, and now unnamed, medical officers at a small federal agency whose existence is perennially imperiled. To my former colleagues and others whom I haven't met, thank you for your selfless service, and for improving the health of all Americans.