Robert Califf

Why Kennedy’s Message on Parental Rights, HIPAA, and Kids’ Medical Records Misses the Point Parents have rights under the Health Insurance Portability and Accountability Act (HIPAA), but so do kids.

This will be a substack worth following. Points here about the complexity of messaging (or lack thereof) from HHS are so important.

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RFK Jr.: “We Need to Stop Trusting Experts” A recent recommendation by RFK Jr.’s vaccine advisory committee shows why trusting experts is still a good idea

Imagine a world with no experts....

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Fall vaccination rates are down, flu takes off, the U.S. is not Denmark, ICE’s negative impact on health, and more. The Dose (December 8)

YLE covers a lot here--most of it concerning, but no reason to give up. A winner is a loser who kept on trying.

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Real-World Evidence for Medicare Drug Price Negotiations This Viewpoint discusses how real-world evidence studies could help the US Centers for Medicare & Medicaid Services align spending with value in their drug price negotiations.

I agree with this. Of course, its all about the methods. I'd go one step further--we need a post-market evidence generation system that incldudes pragmatic RCTs as part of this RWE paradigm.

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A Challenge for our Nation’s Academic Institutions & Health Care Systems, Part 1 The Gap in Prevention and Primary Care

First of a 3 part series unloading my views about prevention and primary care, including my hope that AMCs and health systems will change course.

substack.com/@robcaliff27...

How much should the NHS worry about this winter's flu wave? It's looks like a serious wave, but too early to say it will be worse than recent years and reporting is getting ahead of itself.

When this gets to U.S. our low vaccination rates won't be helpful.

open.substack.com/pub/christin...

Dr. Gottlieb: FDA is systemically trying to dismantle components of the vaccine approval process Former FDA Commissioner Dr. Scott Gottlieb joins 'Squawk Box' to discuss concerns over the FDA's sweeping changes to how the U.S. handles vaccinations, impact on the public trust in vaccines, degradat...

Good discussion of our NEJM perspective from almost all living FDA Commissioners and Interims.

www.cnbc.com/video/2025/1...

The Food System Is Broken. The Narratives About It Don’t Have to Be. Why separating real structural problems from fear-based misinformation is essential for improving health in America.

This is highly recommended. Puts together critical concepts.

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The Food System Is Broken. The Narratives About It Don’t Have to Be. Why separating real structural problems from fear-based misinformation is essential for improving health in America.

This is good.

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A Threat to Evidence-Based Vaccine Policy and Public Health Security at the FDA | NEJM Twelve former commissioners of the FDA express concern that the agency’s recent moves will undermine a regulatory model designed to ensure vaccine safety, effectiveness, and availability.

Almost all living former FDA Commissioners and Acting Commissioners collaborated to express specific concerns about vaccine policy.

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Is Healthcare AI in a Bubble? The Technology is Real. But So Will Be the Shakeout

Good basic analysis of where medical AI is headed

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Better informed consent would be helpful to research participants, while also making research more efficient so we can close the growing gaps in needed evidence and translation from scientific concepts to safe and effective medical products.

Informed Consent: The Opportunity for Digital Technology and Artificial Intelligence This is the third of a three-part series on issues affecting informed consent for participation in clinical research.

Many others have more expertise on informed consent, but I'm convinced we can do better, so I offer my ideas for consideration.

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100%. I'll be posting on this next week, but Dr. Tchang nailed it.

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Opinion | RFK Jr. Turns the CDC Against Vaccines The agency’s website is revised to spread autism fears, despite serious science finding no link.

Concerning message from WSJ editorial board

www.wsj.com/opinion/rfk-...

I was tipped off that this is a deep fake. i guess its a sign of times that i don't know if it is or is not, but Gemeni reports that its not actually a Hinton lecture, but an AI generated lecture to make a point. I guess it did just that--i was impressed by the lecture.

Happy Thanksgiving! A message on all we still have to be grateful for

Good message from Holden Thorpe. Happy Thanksgiving.

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i'm 100% for stepping up our efforts on "life's essential 8"--nutrition, weight control, exercise, sleep, glucose control, blood pressure control, avoid tobacco, but we can do that and prepare for the next pandemic threat!

Opinion | We Can’t Diet and Exercise Our Way Out of the Next Pandemic

A good one. The linked articles are also good.

www.nytimes.com/2025/11/26/o...

YouTube video by The AI Audiobook Google's new AI project is UNREAL | Geoffrey hinton

This nails it in my opinion. The big deal in AI is being explicit about the values that matter. Hinton is not talking about Google, despite the header--he's talking about where we are with AI and what we'd better pay attention to.

www.youtube.com/watch?v=yOC1...

Jennifer Gunter & Eric Topol - Discuss Women’s Health From Dr. Jen Gunter and Eric Topol's live video

For people seeking information on hormone therapy I highly recommend this back and forth between 2 experts at translating information into knowledge.

vajenda.substack.com/p/jennifer-g...

Sweezy v. New Hampshire (1957) Academic Freedom & Cyclical Radicalism

I found this to be a fascinating read from my own institution.

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I'll be writing more about this but while inspections are critical, we can't inspect our way into quality systems for food safety--more is involved, but this is a classic example of Congressional mandates without adequate funding to carry out the job, now exacerbated by the "DOGE effect".

Not good news: The FDA is conducting fewer foreign inspections - Food Politics by Marion Nestle The FDA is reducing safety inspections of foreign food imports, even though much of our seafood, fresh fruit and egetables are imported.

Hopefully this can be turned around.

www.foodpolitics.com/2025/11/not-...

Scoop: The apparent new #2 at CDC is a top ivermectin prescriber who ended Louisiana’s vaccine-promotion media campaigns. The current Surgeon General of Louisiana has made headlines recently, including for allegedly burying a whooping cough outbreak.

Hard to believe, but seems to be for real.

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Why Have We Chosen Not to Fix Primary Care? The Vicious Cycle of Medical Hierarchy | NEJM Luring trainees to primary care requires making its work more tenable and increasing its financial resources. But this recognition won’t lead to change without a transformation of underlying values.

Another good one from Lisa Rosenbaum. You get what you pay for? I am hearing more people in different sectors articulate the serious nature of our US primary care inadequacy.

www.nejm.org/doi/full/10....

This Isn’t Checkmate Reflections from the morning after RFK’s CDC changed its vaccine-autism webpage

Good people speaking out.

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Tragic. Critical to promote reliable information from the biomedicine community.

Have changes to CDC guidelines influenced Americans’ COVID-19 vaccine decisions? A majority of U.S. adults (59%) say they don’t want to get an updated COVID-19 vaccine.

This is not surprising, but disappointing nonetheless. if wthe triple-demic takes off this winter (flu, covid, RSV) there will be excessive an unnecessary death, disability and hospital dysfunction due to the low vax rates and increase in insurance rates.

www.pewresearch.org/short-reads/...

Uncertainty and Consent for Clinical Research This is the second of a three-part series on informed consent as a significant element of our clinical research enterprise that needs considerable work to make it more efficient and effective in gener...

Part 2 on informed consent-dealing with uncertainty.

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