ARI SHAPIRO, HOST:
The federal government's approach to public health has changed more in the last eight months than it has in decades. Since President Trump returned to office, he and members of his administration have challenged the safety of the COVID vaccine, the overall childhood vaccine schedule and the causes of autism. This has upended public health guidance that doctors and patients have relied on for years. Jen Brull is president of the American Academy of Family Physicians. She is with us from Fort Collins, Colorado, to talk about how doctors and patients are navigating this moment. Welcome.
JEN BRULL: Thank you. I'm so glad to be here.
SHAPIRO: Before we get to the broad picture of how the federal government has changed its role in public health over the last several months, what were you thinking as you watched President Trump and Health Secretary Robert F. Kennedy Jr. the other day talking about the causes of autism?
BRULL: I think this is where it's important to separate headlines from science. What I know is that the best science we have today shows no credible link between acetaminophen use in pregnancy and autism. Family physicians have been advising pregnant people for decades to be thoughtful about any medication use, whether it's Tylenol or anything else. And the guidance has always been use it when you need it at the lowest effective dose, and only for as long as necessary. And so when I think about the government releasing a report that changes that credible evidence, it can feel frustrating. And I imagine that it feels frustrating to family physicians everywhere and to parents everywhere.
SHAPIRO: You say it's frustrating when you have the loudest and most powerful voices in the government giving guidance that does not conform to the best science. Is frustrating really the word?
BRULL: (Laughter) I think what worries me most is how these claims land with all sorts of people. Imagine a parent who used Tylenol during their pregnancy and now has a child with autism or an adult with autism who's hearing speculation about its cause. Messages like these can create guilt, doubt or stigma where none is deserved. People with autism and the families who love them deserve compassion and respect, not blame. They need our support, our resources and our continued research that advances real understanding, not speculation that adds to their burden. And while the science today is clear that there is no credible link, the AAFP will thoroughly evaluate any data shared by federal health agencies.
SHAPIRO: Well, a high-profile, televised event is one thing. Broadly speaking, though, what role does the federal government typically play in educating patients and physicians about how best to take care of their health?
BRULL: Typically, the federal government is involved in doing that evaluation of evidence with incredible physician-scientists and other scientists who look at all available evidence, much like the studies that have been done to date about the COVID vaccine, about the pediatric vaccination schedule and about medications used in pregnancy and their safety profiles. They have an incredible, powerful think tank that is able to process a large amount of data, and a pool of experts, and put forth a recommendation that helps physicians, patients, communities make the best decisions about their health.
SHAPIRO: Can you think of a case or a patient you've dealt with where guidance from the federal government made a tangible difference in how you dealt with the case?
BRULL: Oh, absolutely. So in 20 years of taking care of patients in a small community in Kansas - Plainville, Kansas - I used federal guidance all the time when it came to FDA guidance, when it came to the immunization schedule and what made the most sense and got the best results for children who needed an immunization series, the fewest number of shots with the largest positive impact and the lowest risk of side effects. Those were conversations I had with patients every day in the practice of medicine.
SHAPIRO: There have always been doctors who practice what can generously be called alternative medicine. And during the COVID-19 pandemic, a lot of unproven cures and treatments flourished on social media. And the government played a key role in saying here's what works. Here's what's verified, here's what you can trust, here's what you can't. Now that you find yourself on the outside saying what the federal government is saying is not proven by science, is it a kind of Alice in Wonderland, through the looking-glass moment where you're saying don't trust NIH, the CDC, the White House, trust your doctor instead?
BRULL: I wouldn't say that I'm saying don't trust those sources. There are many recommendations that come from those organizations where there are still incredible scientists and physician-scientists who are working hard to ensure that we have access to the best information. My comment instead is if you hear something, wherever that source is - whether it's the television, TikTok or a headline - and you have a question about it, that's the time to have a conversation with the person who knows your health best. A lot of times what we hear through all different sorts of news channels and social media isn't the whole story. And having that conversation is part of understanding the whole story.
SHAPIRO: We are not yet a quarter of the way through President Trump's time in office. And as I said, we have seen more dramatic change than in decades when it comes to public health. How are you thinking about the next three years?
BRULL: The American Academy of Family Physicians has made a conscious choice to continue to engage in the ways that we are able with all of the federal agencies that work on health, social determinants of health and all the pieces that work to ensure that patients across the United States have access to health care and good health care. So we will continue to do what we have done for the last 10 months, which is provide statements that are publicly available about what we see in the evidence. Provide guidance to family physicians and others and patients across the United States on what we see in science-based, evidence-based care. And be clear in that message. Having changes in Washington doesn't mean it's a reason to step back. It is still important that the work that is happening there is informed by those who understand the needs of the population in the United States best, and that is primary care physicians.
SHAPIRO: Dr. Jen Brull is president of the American Academy of Family Physicians. Thank you so much for speaking with us.
BRULL: Thank you. Transcript provided by NPR, Copyright NPR.
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