Responsibilities unasked for and the role of the USPSTF


A commentary in this week’s issue of the New England Journal of Medicine provides some valuable, historical insight into how it was that the U.S. Preventive Services Task Force (USPSTF) ended up with responsibilities that many of its members never wanted.

Many of those who are most irritated by the recommendations that the USPSTF has made about screening (for prostate cancer and for other disorders) may not be aware that the USPSTF had been making controversial recommendations about screening for a wide spectrum of disorders for years. … But their recommendations only became really important when some bureaucrats in Washington, DC, decided to give the USPSTF’s decisions the power of law through the Affordable Care Act (or Obamacare if you prefer).

As you will see if you read this commentary by Johns and Bayer, many of those most intimately involved in the activities of the USPSTF are and were extremely uncomfortable with the unasked for authority that was given to them, and continue to feel that their recommendations should not come with the implied regulatory authority that they were given.

Your sitemaster finds it very interesting that even someone like Helen Darling — a former chief executive of the National Business Group on Health, which represents many large U.S. employers — seems to feel that the regulatory authority should be separated from the recommendation process. Your sitemaster feels the same way.

There is value in having an independent group of clinicians and epidemiologists give their honest assessment of the value of screening tests (although how that evidence is gathered and assessed is a matter for debate). Giving the power of law to those decisions and recommendations, however, is not a good idea. How those decisions and recommendations should be used in clinical practice should be a matter for those with years of experience in issues related to regulatory oversight and issues of health access and insurance coverage.

One Response

  1. Powerful commentary. I have known the former chair, Bruce Calonge, for 40 years. The work they do should not be linked to payment. While I have disagreed with him on prostate cancer recommendations I have great respect for the USPSTF. Thanks for putting this in the InfoLink.

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