Can’t we just let doctors be doctors?
FDA commissioner Marty Makary tried to explain that decisions belong to doctors and patients—not government panels. But CBS’s Margaret Brennan wasn’t ready to hear it.
It was one of the more cringeworthy TV interviews I’ve seen in some time.
Not because the guest said anything shocking, but because the host seemed incapable of grasping a foundational concept of medicine - doctors are meant to treat patients, not guidelines.
When FDA commissioner Dr Marty Makary recently appeared on CBS’s Face the Nation to discuss recent shifts in Covid-19 vaccine policy, he calmly and repeatedly made the case for clinical autonomy.
Decisions about whether to vaccinate healthy children or pregnant women, he said, should rest with “a patient and their doctor.”
But host Margaret Brennan wasn’t having it.
Like much of legacy media, Brennan seemed to expect a single directive from government—a rule to follow, a top-down mandate to repeat.
The idea that different patients might warrant different decisions, or that doctors should assess individual risks and preferences, was met with disbelief.
When Makary noted that 88% of American parents had declined the Covid-19 shot for their children last season, Brennan replied dismissively, “I don't want to crowdsource my health guidance. I want a clear thing.”
But Makary wasn’t endorsing that people crowdsource their medical decisions—he was highlighting that most parents had already made a decision, many of them opting to wait for more robust data before making irreversible choices for their children.
“Maybe they want to see some clinical data as well,” he said. “Maybe they have concerns.”
Makary also challenged the data Brennan was citing—such as the proportion of hospitalised children with Covid-19 who lacked pre-existing conditions.
“The CDC data is contaminated with a lot of false positives from incidental positive Covid tests,” said Makary.
He explained to Brennan that during the Biden administration, the CDC often failed to distinguish between children hospitalised with Covid and those hospitalised because of Covid.
Still, Brennan pressed on, as though the CDC’s statistics were unimpeachable.
Makary went further, criticising the CDC’s Advisory Committee on Immunization Practices (ACIP), which is responsible for making vaccine schedule recommendations. He argued that the committee no longer functioned as an independent body.
"That panel has been a kangaroo court where they just rubber stamp every single vaccine put in front of them," he said.
The minutes of recent meetings, he noted, revealed that the committee prioritised marketing simplicity over scientific rigour.
“They say we want a simple message for everybody, just so they can understand it. It was not a data-based conversation,” said Makary.
He had even written an article for Newsweek, titled “Why America doesn’t trust the CDC,” citing this very issue of oversimplified, universal messaging.
Despite Brennan’s pushback, Makary stayed firm. “The worst thing you can do in public health is to put out an absolute universal recommendation in young, healthy kids,” he said.
This wasn’t an anti-vaccine argument—it was a call for evidence-based medicine.
On the question of pregnancy, the disconnect between Makary and Brennan only deepened.
Brennan cited a 2024 BMJ Global Health review of 67 studies involving 1.8 million pregnant women, which concluded there were no safety concerns with the Covid-19 vaccine.
But Makary reminded her, “There’s no randomised control trial. That’s the gold standard.”
Brennan’s understanding of the hierarchy of medical evidence appeared lacking.
The number of observational studies does not compensate for their inherent limitations—without randomisation, the evidentiary value remains fundamentally constrained.
As is often said of systematic reviews built on low-grade data: garbage in, garbage out.
Makary explained that these studies combined data from widely varying patient groups, making them poorly suited for meaningful safety analysis.
“The data in pregnant women is different for healthy versus women with a comorbid condition. So it's a very mixed bag,” he argued.
Again, Brennan seemed unwilling to accept this.
"The world moves on," she retorted, implying that urgency justified recommending a product before adequate data were available.
But that mindset—acting first, validating later—is precisely what contributed to so many regulatory failures during the pandemic. The precautionary principle should still apply, especially in pregnancy, where the burden of proof must be higher.
Makary rightly pointed out that in the absence of RCTs, it is unjustified to recommend a novel product to pregnant women. That appeared to be the central misunderstanding in Brennan's position.
Medical ethics demand that interventions in pregnancy be supported by rigorous data before they are promoted. Not the other way around. Have we really forgotten thalidomide?
Makary highlighted that a planned randomised trial in pregnant women had been launched—then shut down before the full dataset was known.
“We wanted to see that trial complete so women can have information,” said Makary. “In the absence of data, they should talk to their doctor, and their doctor knows their best wisdom and judgment.”
At this point, Brennan appeared visibly flustered.
“It is still unclear what pregnant women now should do,” she said—seemingly unable to accept that medicine sometimes requires judgment, not pre-scripted commands.
But Makary had been perfectly clear.
What’s unclear is why mainstream media still struggles with the idea that doctors are not simply vessels for CDC bulletins. The physician’s role is not to recite a universal policy—it’s to treat the person in front of them.
Over decades of interviewing doctors, I’ve watched that relationship erode. Increasingly, clinicians tell me they feel pressured to follow rigid guidelines, even when they believe those recommendations don’t suit their patients.
One doctor told me, “If you don’t follow the guideline, and something goes wrong, the first thing the medical board will ask is whether you ‘followed the rules.’ So most doctors do it just to avoid litigation.”
That’s not medicine. That’s box-ticking.
Makary was defending what lies at the heart of medicine — clinical judgment, patient autonomy, informed consent, and the irreplaceable conversation between a doctor and patient.
What Brennan appeared to defend—perhaps unwittingly—was a rigid, top-down model where nuance is sacrificed for simplicity.
A physician once said, “Medicine is part science, part art.” But that art is being stripped away—replaced with diktats from conflicted agencies and a culture that punishes deviation from the script.
What Makary did in this interview was remind us that public health is not a religion, and medicine isn’t a script. It’s a conversation.
It’s just a shame that, on this occasion, the other side didn’t seem to be listening.
FULL INTERVIEW:
When the programs are sponsored by Big Pharma, it’s ‘everyone’s’ responsibility to protect the brand. Public health is a long way down the list.
I have a red T-shirt, courtesy of my membership of AMPS, which says, "Let doctors be doctors".
MSM generally lack any knowledge of medicine or science and resort to "follow the experts" rather than appreciating a nuanced approach to patient care.
Another way of understanding the mindset of the MSM is all left brain and no right brain.
Overall, it's a bit like discussing philosophy with a 2 year old.