By Gianna Melillo
Reed V. Tuckson, MD, FACP, laid bare the challenges faced by physicians in the United States today and offered advice on how to meet them head-on in a fiery keynote speech that opened Internal Medicine Meeting 2025 on Thursday.
“It is an extraordinary pleasure and privilege to be with you, but my heart is burdened this morning, but my fighting spirit is red hot,” Dr. Tuckson began, to a round of raucous applause. Dr. Tuckson, managing director of Tuckson Health Connections, LLC, in Atlanta, called attention to the “extraordinary” current climate around health and science, citing recent federal grant cancellations, mass government layoffs, and controversial appointments to some of the highest positions in public health.
But his talk also touched on more perennial topics, like regaining patient trust and combating mis- and disinformation. “Our fight is a generational fight. This is a long fight,” he said.
Dr. Tuckson challenged the entire health care system to work together to fight these threats, which were exacerbated by the COVID-19 pandemic. On the bright side, he highlighted progress on racial disparities in vaccination rates and life expectancy during that time but added his concern that gaps may have closed due to “politicians and other policy leaders in the red states, red counties, conservative Christian communities … giving information that basically killed their own people,” he said. “That made me realize that this issue of distrust was not a Black issue, minority issue, it is an American issue.”
Equitable access to accurate, understandable, and relevant information for all Americans, “and this is key—to make personally appropriate choices, not elites wagging their fingers at dumb Americans,” is crucial at this moment, he stressed.
Although evidence and science are the lifeblood of what physicians do, the public's level of trust in science has been eroding, typically along political party lines, for a long time, he said.
“This medical freedom movement that is so tied to hostility to scientists, experts, bureaucrats, elites, and big business” and fuels conspiracy theories is not new, he said. However, the recent loss of research grants and funding to combat misinformation and distrust means that physicians have to learn from and lean on each other.
He also criticized the current administration for trying to eliminate "any sense of a diverse voice inside of the biomedical research enterprise." Including diverse populations in research and decision making isn’t only morally and ethically correct but also has practical and fundamental implications, he said.
All of these developments underscore what he calls a “profound disrespect for life.” Dr. Tuckson asked attendees to recall those first few grim weeks of the COVID-19 pandemic, when mobile refrigeration morgues rolled up outside hospitals to hold the overflow of dead bodies.
“You would have thought that would have galvanized this country across the board, saying ‘No! No way!’ And yet we saw just the opposite, that there was a callous disregard for those refrigerator trucks and the bodies inside,” he said.
He also expressed concern about the antivaccination movement, public support of the murder of UnitedHealthcare CEO Brian Thompson, and disturbing instances of health workers who are responding to natural disasters being harassed and targeted by conspiracy theorists.
In response to these and other seemingly insurmountable challenges, Dr. Tuckson offered some tips for attendees who may feel hopeless. “Be in touch with your caring. Be in touch with your irresistible urge to serve, our unquenchable desire to fight for life," he said. “If you get nothing out of this meeting … make sure that you spend a quiet moment in your hotel room tonight and remember the fire that caused you to take on this calling of this profession."
If a colleague or fellow attendee seems down, breathe that life into them too, he said. “No one is allowed to take away my joy. Joy is a radical act of resistance,” he reminded the crowd.
On the public and patient front, he wants clinicians to start building trust. "We have to transform the ability of institutions to care,” he stressed.
Listening is key in this endeavor. “There's a humility that at the population level we have to” get better at, he said. “At the patient level where you live, advance the art and science of listening and communicating with the person, moving from ‘follow the science’ to helping people achieve their goals.”
Every health care encounter should build respect for life, engender trust, and enhance evidence-based decision making, Dr. Tuckson said. He also encouraged physicians to get involved with their local school boards to support their colleagues providing education about science and math.
His final tip: Embrace big ideas. “It can't just be us against them. We can't always be in a defensive posture. We can't always be mad. We got to be for [some ideas].”
Dr. Tuckson concluded his call to action by asking attendees for a relentless, continuing commitment to quality. “But you cannot have a relentless commitment to care quality if you do not have the scientific basis upon which to do it, and so you've got to fight for that,” he said. ■