The Lost Art of Medical Debate—and Why It Matters More Than Ever

The Difference Between Health Policy and Personalized Medicine

I grew up in a household where open debate wasn’t encouraged. My father held a more top-down, authoritarian role. Differing viewpoints were often dismissed—sometimes subtly, sometimes overtly—and affection or attention could feel conditional. What we now call “gaslighting” was, in hindsight, part of the emotional undercurrent.

Each of us—my two sisters and I—developed our own, often unhealthy, strategies for handling disagreement. My eldest sister would go silent and withdraw. The middle one would engage until irritated, then retreat dramatically. I initially tried to mediate, siding more with my dad. Yet, as I matured, I became increasingly aware of the imbalance in whose voices were valued—particularly my mother’s and my own. This awareness sparked louder and more confrontational exchanges between my father and me. Our relationship deteriorated gradually over time, and now, it is non-existent.

I don’t share this to cast blame but to highlight two broader takeaways.

First, what passed for “debate” in our family left my siblings and me unprepared to engage in healthy, constructive disagreement. I’ve had to learn—often the hard way—how to listen, stay present, and exchange ideas without shutting others down. Based on what we now see in public discourse, I know my family wasn’t alone. The culture of the 1970s and 80s often prioritized image over authenticity. The result? Generations of now adults are ill-equipped with the tools or training for healthy debate.

Second, when debate is stifled—whether in families or society—we risk becoming blind to our biases. We lose opportunities to refine our views with new insights. Instead of evolving, we entrench. COVID-19 magnified this at a national and even global scale. Nowhere was this more evident than in the debates over vaccination.

To be crystal clear, I believe vaccines were one of the most significant medical breakthroughs of the 20th century. Throughout my career as a Family Physician, I’ve administered thousands. I followed pediatric guidelines, administered Hepatitis B shots to newborns to prevent passage from in-utero exposure, and supported the childhood immunization schedule. I continue to see the value in many vaccine practices.

Yet, I also believe that questioning is a sign of engaged, critical thinking—not opposition. Today, questioning long-held practices has become code for dissent, and being canceled is a sign of asking questions that fall outside the current thought box. When a topic becomes polarized, people align into rigid camps, often indicating that more space for healthy debate is needed, not less.

For instance, the current U.S. vaccination schedule now includes the COVID-19 vaccine for children at two months old. Personally, I don’t believe a disease that poses minimal risk to young children warrants an annual vaccine without long-term data and study first. I don’t support vaccine mandates. Vaccines—like all medical interventions—should be held to rigorous scientific standards. Yet, I do not believe my view is the only valid one.

The most humbling part of being a physician guide is learning when to say: “I don’t know.” No expert has all the answers. That’s why the psychological method called the 'appeal to authority'—often used in media—deserves scrutiny. Bringing in a credentialed voice doesn’t automatically settle a debate. Policymakers, in particular, operate under constraints that don't allow for the nuance that personalized medicine requires. I wouldn’t want their job, not because of my lack of experience, but because health policy is about communities, while clinical medicine is about individuals.

This distinction matters. Experts can disagree, while both make valid points. Their perspectives often diverge because one focuses on population-level safety, while the other emphasizes individual variation. Both are important.

This week, RFK Jr. suggested that vaccine production be held to the same Gold-Standard protocols as other pharmaceuticals. Specifically, he called for more placebo-controlled randomized clinical trials (RCTs), considered by many the highest level of scientific evidence. Even better, in personalized medicine, we look to meta-analyses—reviews that combine multiple RCTs—to provide a broader, more nuanced picture.


If you’re trying to cut through the noise, I recommend using RCTs and meta-analyses as anchors. They are imperfect but powerful tools. Headlines, podcasts, and social media can provide insight and raise awareness but shouldn’t replace core scientific scrutiny. At the same time, we must recognize that not everything can—or should—be studied in an RCT. Sometimes, patterns observed over the years, applied with discernment and wisdom, move the clinical needle.

Even with a medical background, I sometimes find it difficult to separate truth from tribal thinking. That’s why I’ve also learned to listen to voices at the margins—where new ideas emerge but noise can also distort clarity.

So, how do we navigate this emotional terrain that can block healthy debate for medicine? Start by asking better questions:

• Is this opinion grounded in sound research or economic self-interest?

• Is the perspective shaped by public policy needs or the lens of personalized care?

• Is the pushback coming from fear, profit, or principle?

Giving grace to differing perspectives can reveal insights that would otherwise remain hidden. It should not be a zero-sum game: believing all in a single party or nothing in that party of thought.

Here’s one historical angle that often surprises people. In 1986, the U.S. passed the National Childhood Vaccine Injury Act (NCVIA), signed byPresident Reagan. It created a no-fault compensation system for vaccine injury claims, shielding manufacturers from most lawsuits if vaccines were made properly and labeled. During the COVID-19 pandemic, the PREP Act of 2005 extended similar protections to vaccine manufacturers, distributors, and providers to ensure uninterrupted supply during a crisis.

Conservatives initially supported these laws based on policy needs at that time, but today, we see stark party-line shifts. The party that once promoted manufacturer protections now questions them, and vice versa. The Washington Post, which leans more Left and the party urging scientific scrutiny during COVID, is now questioning Gold Standard practices in an article written 5.1.25 and notice the use of a common medial technique to push their agenda called: 'appeal to authority'. This isn’t to suggest both parties do not use it—it's just an observation that groupthink isn’t confined to one ideology or party. It happens everywhere, and the pendulum is constantly swinging.

I understand the rationale behind these policies of the 1980s and 1990s when litigation culture exploded. Protecting vaccine development made practical sense. However, broad policies don’t easily adapt to evolving science or individual cases. That’s the tension between public health policy-making and personalized medicine—and it’s worth acknowledging rather than dismissing, canceling, or gaslighting.

So, I’ll end with more questions than answers, but also one personal intention: to continue learning to engage in healthy, open-minded debate and encouraging that in my teenager so she is not left ill-equipped when she becomes an adult when the healthy debate is not just important but necessitated.

Debate isn’t about surrendering your beliefs. It’s about giving others the space to hold theirs while seeing your blind spots. Done well, it sharpens your thinking, builds inner confidence, and reveals new dimensions of truth.

If reading this stirred some emotion in you—good. That’s a sign that you’re alive, curious, and engaged.

Keep asking questions. And more importantly, keep listening, not to respond but to learn.


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Be BioFIT- Be Educated, Not Influenced.
Grateful to be your physician guide.

Kevin Hoffarth MD, IFMCP
BioFIT Medicine