The Goat Rodeo

On September 10, 2025, the American College of Physicians (ACP), representing 162,000 Internal Medicine physicians, called on the president and Congress to replace Robert F. Kennedy, Jr., as secretary of the Department of Health and Human Services (HHS), to protect the public health.  In an unprecedented statement for this organization, they described how his actions have undermined and destabilized our public health infrastructure, shown blatant disregard for decades of evidence-based, proven science, and have spread dangerous medical misinformation, sewing chaos and confusion and putting live at risk.  They called for him to be placed with a qualified health expert with appropriate and relevant knowledge and experience.  This is even more remarkable for those of us to remember how his father and namesake advocated so tirelessly and passionately on behalf of his fellow citizens.  This is one apple that fell very far from the tree.

The United States is entering a precarious era in which its cornerstone public health institutions, especially the Centers for Disease Control and Prevention (CDC), face not merely bureaucratic turbulence but existential peril. Under the stewardship of Kennedy at HHS, sweeping alterations to policy, staffing, and public communication practices have been initiated with a disregard for scientific consensus and epidemiological rigor. For clinicians and health care providers who depend upon trustworthy data and evidence-based guidance, the consequences of this upheaval will be profound, both in the short term and for decades to come.

Erosion of Scientific Credibility

The CDC has historically functioned as the nation’s “nerve center” for outbreak response, surveillance, and guidance on communicable and noncommunicable diseases. When its recommendations are perceived as impartial, data-driven, and insulated from political agendas, clinicians can anchor patient care and population health strategies in a shared framework. However, under current leadership, selective citation of fringe studies, elimination of long-standing advisory panels, and a deliberate reframing of scientific uncertainty as evidence of conspiracy risk corroding the CDC’s credibility. Once clinicians begin to doubt the reliability of CDC publications, they may increasingly turn to heterogeneous sources—academic consortia, international agencies, or professional societies—fragmenting what was once a unified public health voice.

The subtle but insidious consequence is a “balkanization” of health guidance, in which disparate institutions issue conflicting recommendations. Clinicians in different regions may rely on differing data streams, producing variability in vaccination uptake, antibiotic stewardship, and emergency preparedness. This fragmentation will undermine efforts to maintain consistent national health standards.

Public Distrust and Clinical Spillover

For the general public, mistrust in the CDC is not an abstraction; it manifests in vaccine hesitancy, suspicion of disease surveillance, and reluctance to comply with public health directives. When the public perceives CDC recommendations as politicized or scientifically compromised, health care providers find themselves in the impossible position of being intermediaries between patients and an institution they themselves may no longer fully trust.

The downstream effect on clinical practice is real: more time spent countering misinformation, greater incidence of delayed or refused treatments, and the spread of preventable disease clusters. Over time, physicians will bear the brunt of the erosion of trust, managing not only clinical illness but also the psychosocial consequences of widespread public cynicism toward science.

The “Invisible” Damage

While the more overt consequences—vaccine refusal, slowed outbreak response, weakened emergency stockpiles—are already the subject of widespread concern, there are more subtle avenues through which this “goat rodeo” undermines public health.

  1. Data Quality Degradation – If surveillance data are selectively suppressed, altered, or de-prioritized, longitudinal epidemiological trends become unreliable. This threatens everything from cancer registries to opioid overdose surveillance, crippling researchers’ ability to detect patterns and forecast interventions.
  2. Professional Exodus – Scientists and epidemiologists faced with censorship or ideological litmus tests are leaving federal service, taking with them irreplaceable institutional memory. Such attrition is harder to quantify than budget cuts but may take a generation to restore.
  3. International Isolation – The CDC has long been a global gold standard. A diminished reputation may lead other nations to rely less on U.S. collaboration, undermining pandemic preparedness, global immunization campaigns, and the credibility of U.S. scientific diplomacy.
  4. Research Funding Distortion – Shifts in HHS priorities toward ideologically driven lines of inquiry (for example, focusing on disproven vaccine-autism claims) will redirect scarce resources away from urgent domains like antimicrobial resistance, environmental health, and chronic disease prevention. This creates blind spots that accumulate silently until crises erupt.

Long-Term Implications for the Profession

Perhaps the most enduring damage will be to the attractiveness of careers in public health. Already beset by underfunding and burnout, the field may now appear to rising cohorts of medical and public health students as hostile, politicized, and professionally unstable. Talented young scientists who might once have joined the CDC or state health departments could instead turn toward private sector roles, global NGOs, or academia.

If this exodus accelerates, the United States will suffer a “pipeline collapse” of qualified epidemiologists, biostatisticians, and behavioral scientists precisely when threats such as climate-driven infectious diseases, synthetic drug epidemics, and bioterrorism demand more capacity, not less. Rebuilding the CDC’s reputation sufficiently to reverse this trend could take decades—if indeed it is possible at all. Trust in institutions is built slowly, over generations, yet can be destroyed in months.

Time Horizon for Recovery

History suggests that institutional recovery is neither swift nor guaranteed. After episodes of diminished credibility—the Tuskegee study, delayed recognition of HIV/AIDS, or controversies during COVID-19—the CDC required years of deliberate transparency, renewed scientific output, and consistent leadership to rebuild trust. The current disruption is arguably more damaging because it emanates from the top of HHS itself, embedding skepticism into the very structure of federal health governance.

Even under ideal circumstances, the restoration of CDC credibility could take 15–20 years, assuming continuous, bipartisan support for depoliticization and reinvestment. Should the current trajectory persist for multiple administrations, the damage may be irreversible, relegating the CDC to a diminished role in both domestic and international health affairs.

Conclusion

For practicing physicians and health care providers, the erosion of a trusted public health anchor is not an academic matter but a daily encumbrance to the practice of evidence-based medicine. The “goat rodeo” unfolding within HHS and the CDC risks cascading consequences: fragmentation of clinical guidance, loss of public trust, silent data deterioration, workforce depletion, and the unraveling of the U.S.’s position as a scientific leader.

The most sobering reality is that these consequences will persist long after the current leadership departs. The work of restoring credibility, rebuilding workforce morale, and re-establishing global scientific partnerships may occupy the entirety of the next generation of health professionals. Whether the CDC can emerge intact depends not only on structural reform but also on the willingness of physicians, scientists, and policy leaders to demand that science—not ideology—remain at the heart of public health.