The Dismantling of Family Medicine: How the Trump Era—and RFK Jr.—Are Undermining Primary Care

From my Day Job

I’ve spent my career in Family Medicine—an often thankless, but foundational field that, when supported, forms the bedrock of a functioning healthcare system. For decades, we’ve fought to shift the American model from reactive sick care to proactive health care—building trust with patients, focusing on prevention, and delivering comprehensive, cost-effective, community-centered services. That progress is now being systematically unraveled.

In recent months, under the banner of “freedom” and “skepticism,” both the Trump-aligned movement and presidential candidate Robert F. Kennedy Jr. have taken direct aim at the institutions that enable primary care to function effectively. Their attacks are not just political theater—they’re policy decisions with real and dangerous consequences.

What’s Being Undone

Two major targets have emerged:

• ACIP (Advisory Committee on Immunization Practices)

• USPSTF (U.S. Preventive Services Task Force)

These are not bureaucratic alphabet soup—they are the scaffolding of modern preventive care.

ACIP makes evidence-based vaccine recommendations that protect public health. Undermining or defunding it, as RFK Jr. has proposed, sends a clear message: science is optional. This threatens herd immunity, allows preventable diseases to resurface, and makes our job as family doctors harder—and more dangerous.

USPSTF, likewise, provides independent, rigorous guidance on screenings and preventive services. Colonoscopies, mammograms, depression screening, hypertension management—these aren’t luxuries. They are life-saving. RFK Jr. has called the task force’s credibility into question and supported efforts to diminish its role, framing prevention as paternalism.

But it doesn’t stop there.

The Broader Attack

RFK Jr. has aligned himself with anti-vaccine rhetoric, conspiracy-based distrust of medical consensus, and deregulatory platforms that would fragment care even further. Meanwhile, under Trump’s previous term:

• Medicaid expansion was threatened, cutting off access for millions.

• Public health leadership was gutted, with resignations and firings across CDC, HHS, and NIH.

• Primary care payment reform was stalled, leaving Family Medicine underfunded and overburdened.

This slow dismantling isn’t just bad policy—it’s an ideological shift away from collective responsibility for health. It erodes trust. It punishes the very idea of coordinated care.

Why This Matters

In every other high-income country, prevention is the priority. Nations with stronger primary care infrastructures spend less on healthcare overall—and get better outcomes.

Family Physicians are uniquely positioned to address not just acute illness, but the social determinants of health: food insecurity, chronic disease management, mental health, addiction, and community resilience.

But only if we’re empowered to do so.

When federal guidelines are politicized, when prevention is undermined, and when experts are dismissed as elites, we’re not just dismantling systems—we’re abandoning patients.

The Path Forward

This is a call to my colleagues—and to anyone who believes in the value of science-based, compassionate care:

• We must defend the role of evidence in health policy.

• We must push back against rhetoric that vilifies expertise.

• We must remind the public that primary care saves lives, not just money.

Family Medicine is not a special interest. It’s a national interest.

And we are not going away quietly.