Modernizing the Healthcare Workforce for a Chronic Disease Era
On February 24, 2026, the House Ways and Means Health Subcommittee convened a hearing entitled, “Advancing the Next Generation of America’s Health Care Workforce.” While much of the discussion focused on the looming shortage of 187,000 physicians by 2037, the testimony of ACSM member Jennifer Trilk, PhD, FACSM, DipACLM, offered a roadmap for shifting the focus from simply increasing the number of doctors to improving the quality of their preventive training.
Representing the University of South Carolina School of Medicine Greenville, Dr. Trilk argued that the current Graduate Medical Education (GME) system is “fiscally unsustainable” because it over-prioritizes pharmacology at the expense of lifestyle interventions.
A central theme of her testimony was the critical need for physical activity to be treated as a standard clinical tool. Key highlights included:
- Clinical Competency vs. General Advice: Dr. Trilk emphasized that telling a patient to “move more” is insufficient. She advocated for a workforce trained in specific exercise prescriptions—understanding the exact “dosage” (intensity and duration) required to manage conditions like hypertension or initiate the remission of Type 2 diabetes.
- The “Clinic-to-Community” Pipeline: To reach rural and underserved populations, Dr. Trilk highlighted models that move medical training beyond hospital walls. She detailed how partnerships with community hubs—such as YMCAs and senior centers—allow residents to treat patients where they “live, work, pray, and play,” making physical activity a socially supported lifestyle change rather than just a medical directive.
- Physician as Role Model: Citing data that physicians who are physically active are significantly more likely to counsel their patients on exercise, Dr. Trilk argued that incorporating wellness and physical activity into medical residency is a key strategy for both improving patient outcomes and reducing physician burnout.
- Biological “Miracle-Gro”: She touched on the science of neurogenesis, noting that medical training should reflect how physical activity increases Brain-Derived Neurotrophic Factor (BDNF), essentially acting as “biological medicine” for the brain and metabolic system.
The subcommittee also heard from experts like Dr. Emily Hawes and Mr. Jason Shenefield, who addressed the financial barriers rural hospitals face when trying to establish residency programs. The consensus among witnesses was clear: solving the healthcare crisis requires lifting the 1996 “frozen” caps on Medicare-funded residency slots and ensuring the next generation of doctors is equipped to address the root causes of chronic disease through nutrition and movement.
Senate HELP Committee Hearing: Nomination of Dr. Casey Means
The Senate Committee on Health, Education, Labor, and Pensions (HELP) convened a hearing on February 25, 2026, to consider the nomination of Dr. Casey Means for the dual roles of Medical Director in the Regular Corps of the Public Health Service and Surgeon General of the Public Health Service.
Dr. Means, the sole witness, argued that the U.S. health system is currently built for “reactive sick care” rather than health promotion. Her testimony centered on the metabolic health crisis, citing the alarming rates of obesity and pre-diabetes.
Key Highlights:
- The “MAHA” Strategy: Dr. Means echoed the “Make America Healthy Again” agenda, which prioritizes nutrition and physical activity. She explicitly mentioned designating “physical activity as a vital sign” (PAVS) as policy.
- PAVS has long been a pillar of ACSM’s Exercise is Medicine program. Learn more.
- Technology & Wearables: Dr. Means highlighted the role of continuous glucose monitors and other biosensors in empowering patients to take ownership of their metabolic data.
- Lifestyle over Pharmaceuticals: While the hearing included intense debate over vaccine policy and medical qualifications, Dr. Means’ primary message was a call for “whole, healthy foods” and lifestyle interventions to keep Americans out of the operating room.
Dr. Means placed emphasis on preventative metabolic health, potentially representing ongoing increased opportunities to continue to advocate for physical activity as crucial component of the prevention and management of chronic disease, however some senators raised concerns regarding her lack of a traditional clinical practice record. If confirmed, she would oversee the 6,000-member Public Health Service Commissioned Corps.
State of the Union 2026: A New Direction for U.S. Healthcare
In his February 24 State of the Union address, President Trump signaled a major shift toward a consumer-directed healthcare model. Highlighting the recent surge in insurance company profits, the President expressed a strong preference for direct-to-public funding over traditional insurance structures. Central to this vision is the “Great Healthcare Plan,” a legislative push aimed at:
- Lowering drug prices and insurance premiums
- Increasing price transparency across the board
- Holding major insurance carriers accountable
The Administration is also calling on Congress to codify “Most Favored Nation” drug pricing and is touting TrumpRx—a new platform for purchasing discounted medications outside of traditional insurance. Additionally, Vice President JD Vance has been tapped to lead a new task force dedicated to eliminating fraud within Medicare and Medicaid.
NIH Director Appointed as Acting CDC Director
NIH Director Dr. Jay Bhattacharya was appointed as Acting CDC Director, while maintaining his current role. The announcement follows the departure of HHS Deputy Secretary Jim O’Neill, who was also serving as Acting CDC Director. Additionally, Secretary Kennedy announced that he was elevating the CMS Director for Medicare Chris Klomp to Chief Counselor for HHS, and CMS Chief Policy and Regulatory Officer John Brooks to Senior Counselor for CMS. Secretary Kennedy is also elevating Kyle Diamantas, Deputy Commissioner for Human Foods at FDA, and Grace Graham, Deputy Commissioner for Policy at FDA, to Senior FDA Counselor positions in his staff. Each of these individuals will also retain their current roles within CMS and FDA.
