There are some things we know about President-elect Donald Trump's pick for Secretary of Health and Human Services, Tom Price. He's anti-abortion, as demonstrated by his track record of supporting abortion-blocking or banning bills as a House Representative, and is no fan of Medicare. But Price, an orthopedic surgeon, is also a member of a controversial group that could reveal even more contentious views than the ones he's expressed publicly.
Founded in 1943, the Association of American Physicians and Surgeons (AAPS) is a professional organization for doctors that promotes physician autonomy, and counts Price as a member. It also believes Medicare and Medicaid are unconstitutional, has linked abortion to an increased risk of breast cancer (this link has been debunked), and raised the question of whether President Barack Obama may be a hypnotist.
As head of the HHS, Price will have influence over the Centers for Disease Control, the Food and Drug Administration, and the National Institutes of Health, which is why some critics are worried his affiliation with the AAPS could spell disaster for regulation, funding, and facts.
"The principles that unite us are the belief in the sanctity of the patient-physician relationship," Dr. Jane Orient, the executive director of the AAPS, told me over the phone. "[As well as] the need for private medicine where the physician is working for the patient, not the government or some third party. The physician has the obligation—which is in the oath of Hippocrates—to prescribe for the patient's good, not for the population's good, according to his best judgement not according to some authority."
These guiding beliefs mean that the AAPS is more political than your average doctors' organization. Because the group believes in physician autonomy and obligation to the patient, anything that might infringe on that—from public medicine, to health insurance, to government regulations—is seen as a threat. That means mandatory vaccines, Medicaid, and even evidence-based guidelines are all in AAPS's crosshairs.
The group opposes all public medicine—including Obamacare, Medicaid and Medicare—and believes doctors have a moral obligation to never perform abortions. AAPS has also raised eyebrows for some of the studies it publishes in its journal, the Journal of American Physicians and Surgeons, which include anti-vaccine rhetoric (its more recent issue opposed mandatory flu vaccines for medical workers) and criticisms of evidence-based medicine. Much of the research the journal publishes—such as this recent paper advising against giving children multiple vaccines—contradicts the consensus of decades of medical research from all leading institutions.
"What worries me about a member of that organization controlling the HHS, is that organization is not about evidence, it's not about crafting good government policies," said Dr. David Gorski, a surgeon and the managing editor of the blog Science-Based Medicine, who wrote a blog post about his concerns last week. "[The AAPS has] an almost Ayn Randian view of medicine where the doctor is John Galt."
According to Orient, Price was a member through 2016. I reached out to Price's office to see if they had any kind of statement on his affiliation with the AAPS, but did not receive an immediate response. (I called his office, where a staff member asked me to email his press secretary, which I did three times, with no reply yet.)
Gorski pointed out that just because Price is a member of the AAPS does not mean that he subscribes to all of the group's theories. And Orient noted that just because a study or editorial is published in the AAPS's journal does not mean that it represents the official position of the organization, or its members. But many of the criticisms of AAPS—that it's anti-Medicare, anti-abortion, and anti-evidence—are true.
"We were against Medicare from the beginning and we still take the stand that it's unconstitutional," Orient told me. "We are not in favor of abolishing it instantly because a huge number of people, obviously, depend on it. But we do encourage physicians to opt out. That does not mean that they abandon their Medicare patients, they can offer their services at a price that's mutually agreeable."
Orient also confirmed that the AAPS "believes in the sanctity of life" and that doctors should not perform abortions. She also told me that the organization is not anti-vaccine, but is against mandatory vaccinations. When I brought up concerns about the loss of herd immunity and new outbreaks, such as the measles outbreak in 2014, Orient told me that outbreak was "brought in by foreigners." (There is no evidence this is true.)
"It makes me worry that we're looking at ideology triumphing over evidence."
As for the article that raised the possibility that President Obama might be inducing the public into a hypnotic trance with his oratory skills, Orient told me that was simply a topic of debate—and emphasized that AAPS posted it more than eight years ago—but she also didn't completely discredit the theory.
"Neurolinguistic programming is a well-known method of hypnosis, it's in the literature," Orient said. "Orators, throughout history, can have a very malignant influence on people. They can transfix the population and get them to do things they otherwise would never do."
Though things like vaccine regulations are dealt with at the state level, groups like the CDC have a lot of influence—many states base their regulations on the CDC's guidelines. Price's affiliation with AAPS could spell a major shift in how our government approaches medicine.
"A group that is so much about the supremacy of doctors, the free market, and not so much about evidence makes me worry that we're looking at ideology triumphing over evidence," Gorski told me. "Obviously the things Price has said and done matter more, but they're not inconsistent with being a member of the AAPS."