Physician Groups, SEGM Push Back on STAT Essays
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- AAFP, ACP, and AAP — led by presidents Sarah Nosal, Jan Carney, and Andrew Racine — argued U.S. healthcare needs both primary and specialty care, not a zero-sum choice, citing data that adults with a usual source of primary care receive recommended preventive services at 95.5% vs. 67.6% without.
- The three organizations cited figures showing primary care continuity cuts emergency department visits by 11% for adults and avoidable ER visits/hospitalizations by 50% for children, with roughly $700 lower costs per visit and up to 10% lower overall spending.
- Jeffrey Millstein of Penn Medicine countered the original essay, arguing the real primary care problem is fragmented care, poor time-sensitive access, and task-overload — not primary care's role as a 'sole lever' for population health.
- Millstein pointed to MedPac data showing most Medicare patients can see their PCP within two weeks, but said acute-illness access gaps push patients into urgent care and ERs and generate non-essential specialist referrals.
- SEGM objected to being called 'an anti-trans group' in Dr. Kavitha Ranganathan's essay, saying the label misrepresents its mission of advancing evidence-based care for youth with gender dysphoria.
- SEGM's William Malone said the organization collaborates with researchers from 30+ countries and rejects conflating scientific inquiry with political advocacy, calling for open debate on evidence quality rather than suppression.
- Millstein framed primary care payment reform as fairer reimbursement for cognitive work to expand the workforce and improve continuity — explicitly rejecting the 'robbing Peter to pay Paul' framing.
Why it matters: Three of the most influential U.S. physician organizations (AAFP, ACP, AAP) — representing family physicians, internists, and pediatricians — jointly entered the Medicare payment reform debate, lending institutional weight to calls for change to budget neutrality rules. Separately, SEGM's formal rebuttal escalates a growing dispute over how evidence-based scrutiny of pediatric gender medicine is characterized in medical media, with the group demanding retraction of the 'anti-trans' label.
