When Science Speaks, Who Listens? A Look Back at Restrictions on VA Researchers

It's a significant issue when doctors are unable to share what they're seeing. And it's even more significant when it affects those who have served our country. We recently learned about a concerning time for medical professionals at the US Department of Veterans Affairs (VA) during a past administration – specifically, under Donald Trump. It seems there was a period where VA doctors and scientists were told they couldn't publish their findings in medical journals or even speak to the public without getting the green light from political officials first.

Photograph: Jon Bilous/Alamy

This order, which came out in emails on a Friday from senior VA officials, happened just hours after a major medical journal, the New England Journal of Medicine, published an article. This particular article was written by two lung specialists who worked for the VA in Texas.

One of the VA officials, Curt Cashour, who was then the assistant secretary for public and intergovernmental affairs, was pretty clear in his email, saying, "We have guidance for this. These people did not follow it." He even attached the very article that had just been published.

What was so controversial about this article? Well, doctors Pavan Ganapathiraju and Rebecca Traylor, the authors, were raising some serious alarms. They wrote about how changes like cancelled contracts, layoffs, and a planned reduction of 80,000 employees in the VA healthcare system could really hurt millions of veterans. These veterans were seeking help for health problems linked to toxic exposures, from Agent Orange in Vietnam to burn pits in Iraq and Afghanistan.

As they put it, "As pulmonologists in the Department of Veterans Affairs (VA), we have been seeing increasing numbers of veterans with chronic bronchitis, pulmonary fibrosis, asthma, and other respiratory conditions." They also pointed out that while Congress had expanded the list of conditions linked to military service, "legislation doesn’t care for patients, people do." It was a powerful reminder that real people, not just laws, provide care.

Not surprisingly, this article got an immediate reaction from Trump’s political appointees. Internal emails showed another senior adviser, John Bartrum, reminding everyone that they needed to follow VA policy. Cashour, the assistant secretary, even stated that approval for anything published in national media had to come from his office. Local directors were told to tell Washington "as soon as possible" about anything that could lead to "negative national exposure."

Now, the VA's press secretary at the time, Peter Kasperowicz, said that this policy was just about making sure employees coordinated with public affairs before talking to the media. He said pretty much every organization, both in and out of government, has similar rules, and that this policy had been around for years under different administrations.

But Dr. Ganapathiraju saw it differently. He told The Guardian that his article followed all VA rules, which actually encourage employees to publish in “peer-reviewed, professional or scholarly journals.” The rules said that coordinating with public affairs was encouraged, but not a must, when sharing personal or academic opinions. He also shared that he and his co-author hadn't faced any punishment, and in fact, had received a lot of support from other VA doctors and chiefs across the country.

However, many VA workers and veterans' advocates felt that these warnings were part of a bigger pattern. The called it a "war on science" by the Trump administration. Critics pointed to things like billions of dollars in cuts to medical research grants and a "climate of fear" that put independent research at risk. Nearly 2,000 leading scientists, including Nobel Prize winners, even signed an open letter about it.

Kasperowicz, the VA press secretary, called it "absurd" to suggest that enforcing their media policy was part of a "war on science."

It's worth remembering that during that time, in May of that year, Trump had even issued an executive order called “Restoring Gold Standard Science,” where he accused his predecessor, Joe Biden, of misusing scientific evidence. Thousands of academics protested this, saying it could lead to political meddling in science. There was even talk from the then-Secretary of Health and Human Services, Robert F. Kennedy Jr., about potentially banning government scientists from publishing in top journals, calling them "corrupt."

The VA has always been a really important place for medical research in the US. With almost a billion dollars from Congress each year, VA scientists work at over a hundred research sites, doing thousands of projects and publishing tons of papers. They've given us amazing things like the nicotine patch, the pacemaker, and the CT scan. They even run a center dedicated to PTSD, which has helped so many, not just veterans.

Harold Kudler, a psychiatrist and researcher who had worked for the VA, said that the backlash against the pulmonologists' article was "powerful in its impact and frightening in the threat it represents." He called it "another attack on freedom of speech" and warned that "Veterans will suffer because of it. Plus, all research programs will take note."

When those in power try to control what information gets out, especially from those who are on the front lines of healthcare and research, there's a lot at stake. For our veterans and for the future of medical science, it's vital that truth and independent research can always shine through.