Key takeaways:

  • Two USPSTF leaders were fired after being told they had been “inappropriately appointed.”
  • Experts expressed concerns over the future of the task force and how its instability could impact public health.

HHS Secretary Robert F. Kennedy Jr. has fired both vice chairs of the U.S. Preventive Services Task Force, according to letters obtained by Healio.

The vice chairs were Esa M. Davis, MD, MPH, FAAFP, a professor at the University of Maryland School of Medicine, and John B. Wong, MD, MACP, a professor at Tufts University School of Medicine.



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According to the task force’s website, Davis was appointed vice chair in March 2025. She previously served as a member from January 2021 to December 2024. Wong was appointed vice chair in March 2024. He previously served as a member from March 2018 to December 2023.

Davis was supposed to serve as vice chair until March 13, 2027, and then chair until March 13, 2028, according to her appointment letter. Wong’s term was set to end in March 2027, according to reporting by Reuters.

Alex H. Krist, MD, MPH, a former USPSTF member, told Healio that the task force now consists of eight members, although no chairs or vice chairs remain. The task force usually consists of 16 members, but it has been a while since new members were appointed.

Firings followed a review of appointments

In the letters, dated May 11, Kennedy said that he ordered a review of current USPSTF appointments “to ensure clarity, continuity and confidence in the [HHS’] exercise of its appointment and supervisory responsibilities, and to protect the integrity of the Task Force’s work.”

He said that Davis’ and Wong’s firings, which are effective immediately, were a result of the review and done “to avoid uncertainty that could jeopardize the validity of future Task Force actions.”

The terminations are not reflective of Davis’ and Wong’s years of service or performance on the task force, Kennedy added, but that HHS “is taking this step to help protect the Task Force and preserve confidence in the continuity and durability of its work.”

Kennedy encouraged Davis and Wong to reapply for USPSTF membership during the nomination cycle ending on May 23 as their “continued participation would be highly valued.”

Wong told Healio that the firing was a surprise, but that he and Davis submitted requests to rejoin.

“We believe very much in the work of the task force. Our goal is to help and keep people healthy to live longer, healthier lives,” he said.

When Wong asked if they could restore their chair statuses, he was told that they would only be considered for member roles, not leadership roles.

‘Inappropriately appointed’

In a letter to Roger D. Klein, MD, JD, director of the Agency for Healthcare Research and Quality, and Benjamin Robles, HHS deputy general counsel, Davis and Wong said they were told they had been “inappropriately appointed” during a meeting on May 12, which would make their chair tenures “invalid.”

“Importantly, Secretary Kennedy’s termination letters neither state nor imply that our original appointments were somehow unlawful or inappropriate,” Davis and Wong wrote. “To the contrary, he implicitly confirms our validity by thanking us for our ‘many years of dedicated service to the Task Force’ which, by definition, would include January 2025 through the present.”

When Davis and Wong asked for further clarification, “the response Dr. Klein provided to us was that our specific questions implicate legal and policy judgments that would not be appropriate to address in external correspondence,” Wong said.

“The external part is that we’re no longer part of the task force, so it remains unknown to us exactly why in this context. But I can say the timing of this coincides with a solicitation for new task force members,” Wong said.

HHS did not respond to Healio’s questions about why Davis and Wong were let go and whether the agency believes their appointments were in fact inappropriate.

Kennedy not wanting Davis and Wong in leadership roles “is one of our areas of confusion,” Wong said.

“There are some very nice compliments about early contributions and our expertise. He even says they’re deeply valued,” Wong said.

Criticism from medical societies

Uncertainty surrounded the USPSTF for months. Under Kennedy’s tenure, three task force meetings have been canceled since July 2025, and the USPSTF has published far fewer recommendations than under prior administrations.

AMA President Bobby Mukkamala, MD, said his organization “is extremely concerned” about the terminations.

“Today’s changes were foreshadowed by the earlier dismantling of the Advisory Committee on Immunization Practices,” he said in a statement. “We strongly urge HHS to restore the USPSTF’s long-standing, transparent process for selecting members, specifically clinicians with expertise in the fields of preventive medicine and primary care.”

Mukkamala also urged HHS “to commit to once again holding regular Task Force meetings to ensure its important work can continue without further delay. Our patients’ lives depend on it.”

ACP President Jan K. Carney, MD, MPH, MACP, said in a statement that Davis and Wong “serve as important representatives for internal medicine physicians and the patients that we care for. Both physicians are highly qualified experts, and we take issue with the lack of transparency in any review that Secretary Kennedy has conducted of members of the task force.”

“The firings come as the task force has not met over the course of the past year and has been prevented from doing their work to ensure that the American public has up-to-date guidance, based on the best-available evidence, about preventive health care services. The USPSTF guidance is critical to a healthy America, and we must not allow its membership or processes to be politicized,” Carney said.

‘It’s going to be hard to trust’ future guidance

Without chairs and vice chairs leading the task force, Krist said there is great concern that incoming members will not receive the necessary training and education.

“There was a process where every new task force member was assigned a senior task force member as a mentor. That’s been an established process used internally for decades,” he said. “The mentor is really helping to make sure that new members are able to adopt and adhere the task force’s methods and approach, be able to do the volume of work effectively and focus on the things that matter. The chairs were so instrumental at training and leading.”

Wong noted that, “historically, all the chairs have already been members of the task force and have completed their 4-year terms as task force members.”

“They not only have that clinical experience and expertise in evidence-based preventive health, but they also have 4 years of working with our processes and procedures, which have been endorsed as gold standard methods for developing guidelines in the Institute of Medicine, now National Academy of Medicine, guidelines,” he said.

Some are concerned that Kennedy could diminish the standards of the USPSTF by appointing unqualified task force members.

“This is a scary time as to what’s going on, because primary care clinicians and those practicing prevention have come to trust the task force. They trust it partly because of the methods and the rigor, but also partly because they trust and know the members of the task force,” Krist said. “They know there are no conflicts of interest. They know that the task force members are going to stick to and adhere to the methods and approaches that the task force uses to objectively come up with the state of the science and what works and what doesn’t work.”

Krist continued that unless leaders in prevention are appointed — “primary care clinicians, not topical experts, who understand the task force methods and are willing to implement those methods — it’s going to be hard to trust future recommendations from the task force.”

The effects of the turnover at USPSTF are being felt across clinical practices even now, Krist said.

“The task force hasn’t made a new recommendation since August of last year. There are all kinds of new preventive services coming out, and the state of the science on existing preventive services is changing every day. People don’t even realize we have this knowledge,” Krist said. “It’s unconsciously incompetent that we don’t know what’s going on because the task force hasn’t been able to release updates and recommendations and evaluate new services.”

For example, Michael Silverstein, MD, MPH, past chair of the USPSTF, noted that the USPSTF has yet to finalize its 2024 draft recommendation for cervical cancer screening, which for the first time included a self-collection option. Silverstein told Healio that this recommendation would have been “significant for clinicians and extraordinarily significant for women.” It is among the “most egregious examples” of the task force’s work that has been suppressed in the last year, he said.

In addition to determining health insurance coverage, Krist said “the task force recommendations give clinicians confidence that they know what and what not to recommend. As clinicians lose confidence in what or what not to recommend, we’re going to see greater gaps in people receiving preventive services that are necessary,” Krist said.

There are also possible financial consequences.

“The task force’s job is not only to recommend what works, but to recommend what doesn’t work, and that helps to make sure that we’re having high value for prevention and that we’re, as a nation, spending money on the preventive services that we should be spending money on,” Krist explained.

The USPSTF is also tasked with identifying gaps in evidence, which members report to Congress and federal agencies like the NIH, Krist said.

“That helps to define the research agenda for the nation for prevention,” he said. “So, our funding agencies are going to lose that rudder for steering and telling them what we should or should not be studying. The implications are just astronomical for public health production.”

Ultimately, “it’s a wait and see process with some uncertainty,” Wong said. “We can hope that the membership of the task force is comprised of primary care clinicians. Short of that, we would hope that any subspecialists who have expertise in evidence-based medicine, who may have expertise in preventive care — but most importantly to me, can think critically about the evidence — take on the population perspective; that they’re making decision judgment based on the evidence about the balance of benefits and harms, and the quality of the evidence. That is a great power and responsibility.

“There is a 40-plus-years trust in the recommendations of the task force for those populations, and I hope they can preserve that trust,” Wong said.

For more information:

Alex H. Krist, MD, MPH, a professor at Virginia Commonwealth University, Michael Silverstein, MD, MPH, and John B. Wong, MD, MACP, can be reached at primarycare@healio.com.

Sources/Disclosures

Source:

Healio Interviews

References:


Disclosures:
Healio could not determine relevant financial disclosures at the time of publication.

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