One of our most powerful tools for biomedical research is PubMed. This thorough and easily searchable database is the national public health and medical research library housed under the National Institutes of Health (NIH). PubMed contains more than 37 million citations for biomedical literature derived from MEDLINE (the premier bibliographic database that contains journal article references in the life sciences), life science journals, and online books.

Frankly, without PubMed, I would be unable to write most of the articles that I have published here. For example, when I see some claim that makes my skeptical radar go wild, I search PubMed to determine if there is any published evidence supporting such claims.

For almost any biomedical research, PubMed is where research starts.

Unfortunately, with Robert F Kennedy Jr, and his pseudoscientific beliefs, in charge of the Department of Health and Human Services, which runs NIH and therefore PubMed, I worry that PubMed may be neutered or, worse yet, become unavailable to the public.

That will mean that access to biomedical research that we all use to further science-based medicine could be destroyed. And that means false claims about health and medicine will be much more difficult to refute and debunk.

This post reviews what RFK Jr could do to lessen the importance or availability of PubMed to researchers. And none of it is good.

What is PubMed?

According to the PubMed website, it is a free database that supports the search and retrieval of biomedical and life sciences literature to improve health and health research. The database contains more than 37 million citations and abstracts of biomedical literature.

It does not include full-text journal articles, but it does provide links to the full texts that may be available on the publisher’s website or PubMed Central (PMC). Generally, PubMed provides the abstract, which is both valuable and can be misused, since it may not provide important information like methods, statistical analyses, and other critical information.

PubMed averages over 3.5 million users each day, not at the level of Amazon which gets nearly 200 million users each day, but very good as government websites go. According to Statista, only the US Postal Services gets more visitors than does PubMed among government websites.

The most important role of PubMed is that it is a robust journal index, and it is easier to use than other databases. For example, if you try to search for a particular article on a journal’s website, it may not give you the results you want, even if you can figure out how to use it. I just don’t search articles on those websites anymore.

Furthermore, indexing journals has another key role — it usually prevents the inclusion of predatory journals. What is a predatory publisher? They are an exploitative open-access publishing model that involves charging publication and other fees to authors without providing the editorial and publishing services associated with legitimate journals (open access or not). Although predatory publishers occasionally use some sort of a peer-review process, it is not as robust or unbiased as you would find with higher-quality journals.

PubMed mostly weeds out low-quality journals including many predatory journals, which helps keep out most bad and/or fraudulent research. This makes sure that results in a PubMed search are mostly published in respected journals and reduces the influence of fraudulent research and articles. Furthermore, the database is kept up-to-date, so retracted articles are clearly shown.

The PubMed index is not perfect. As I mentioned above, it mainly shows the abstracts of articles without any of the important analysis and discussion sections. People who use the database need to use critical thinking skills to read, analyze, and summarize the information from information derived from the PubMed database.

So what could RFK Jr and his minions do to PubMed? I listed out several worries that I have.

Take PubMed offline

As we have seen with the CDC databases, RFK Jr could order that PubMed be shut down or taken offline. Or it could be put behind a paywall, forcing those of us who want to use it to pay for something that should be covered by taxpayers.

Some archives could be used to save the database, but it will become dated and stale after a few months as it will not include the most recent publications.

Stop updating the database

He could lay off everyone involved with the management of the database so that it is never updated. It may still be available for all to use, but it will become a snapshot in time without any current information.

Fewer full articles

In 2022, the Biden administration issued a new policy that requires that all taxpayer-funded research be publicly accessible by 2025. Papers that discuss research generated by NIH grants were to be included in the PubMed and PMC databases.

RFK Jr could revoke that policy and all of that NIH-funded research will be shut behind paywalls again.

Mess with the indexing system

The new administration could change the indexing system by punishing journals that have published articles that the administration doesn’t like. A journal could publish another article that shows that vaccines do not cause autism, and suddenly that journal is no longer published. Or it could punish journals that discuss climate change and public health. Or gun violence and children’s health. The list is long.

Alternatively, they could force indexing of journals that support their viewpoints. They would “flood the zone” with bad research in low-quality journals that are now searchable in the database.

That would remove the few safeguards we have against bad science.

Essentially, the administration could only allow “scientific research” that supports its worldview while de-indexing real science. That would make PubMed essentially useless, worse than just shutting it down.

Is PubMed really at risk?

I don’t know if access to PubMed is at risk. Unfortunately, I have not seen one bit of positive news from Health and Human Services since RFK Jr took over. His anti-science and anti-vaccine nonsense will take precedence over real science, and PubMed is one place where science is mostly paramount.

I was quite worried about PubMed on day 1 of the Trump administration — I searched for a vaccine article that had recently been published, and I was pleasantly surprised that it was indexed. Every day I go to the website, I am concerned about what I might find.

I am not optimistic.