It’s important to know as much about our next presidents as possible—their policy positions, their temperament, even their health information, given the possibility of electing a president who isn’t long for the office. But it’s also clear that as long as candidates can cherry-pick their physicians, they can essentially cherry-pick their medical reports, too.

There is a way to try and fix the broken system, and it was former President Jimmy Carter who helped identify it. In 1994, more than a decade after he left office, Carter floated an idea in the Journal of the American Medical Association: An independent commission to evaluate the health of the president, in case of disability. Carter’s proposal never went anywhere, but was a high-profile acknowledgement that medical fitness for the presidency should be taken seriously, and de-politicized as much as possible.

Mariano says that she served on an American College of Physicians subcommittee that looked at a similar proposal to require presidential candidates to undergo an independent medical evaluation, although the idea was eventually shelved. “We debated it back and forth, and then reality set in,” she says. “Most candidates bristle at releasing private information” and might seek to avoid a medical review.