A secretive working group is devising a plan to create a medical panel that would screen the health of the president and other candidates in the hopes of determining that President Trump is not fit for office or stopping another like him.

The public face of the five-person group, most of whom have decided to remain anonymous, is Dr. Bandy Lee, a Yale University psychiatrist who edited a controversial book of essays concluding Trump is dangerous to the country because he has shown he is mentally unfit.

“Based on the experience with the current president, we are calling for regular fitness for duty exams on presidential and vice presidential candidates, preferably as a requirement sometime before they take on the job, and even preferably before they run,” Lee said.

Lee's group realizes that Congress won't enact such a requirement, which would include annual exam every year after winning the election, and instead is looking to demand that candidates voluntary submit to being examined by the panel.

They plan to publish a proposal and make the case that the medical panel is needed to prevent mentally unfit people from entering high office.

“We would like to keep this entire process as voluntary and confidential as possible, but also in a democracy we believe the public has a right to know if a dangerous person is pursuing the presidency,” Lee said.

The book Lee edited, The Dangerous Case of Donald Trump, outlined a model for an independent medical panel. The idea in the book was for Congress to create the panel, but now the group is finding a way to set it up without lawmakers.

The panel would have three neuropsychiatrists — one clinical, one academic, and one military — one clinical psychologist, one neurologist, and two internists. The mental and physical evaluations would be confidential, unless candidates choose to reveal them or insist on running despite unfitness.

The medical experts would be nominated by an outside organization, such as the highly respected National Academy of Medicine, and serve for six-year terms, with one rotated out and replaced every year.

“It’s just like having a medical checkup to make sure you qualify before going ahead,” Lee said. “Any reasonable person should be able to submit.”

The Washington Examiner asked the campaigns of the 10 Democrats who have announced their candidacy whether they would submit to the medical exam and whether they planned to release their health records. Inquiries also were sent to the Trump campaign and to Howard Schultz, the former Starbucks CEO who said he’s considering running as an independent.

The campaign for Andrew Yang, a former official in the Obama administration and tech entrepreneur, was the only one to respond.

"I do believe that the president, and candidates for the office, should undergo a physical and mental health examination," Yang said. "I'd be happy to submit to an examination by an independent body, with the overall conclusion as to fitness to serve being publicly shared. I also believe this should be a regular occurrence throughout the presidency.”

Lee's book, which argues that psychiatrists have a responsibility to warn the public when a president is dangerous, is controversial because psychiatric associations urge members never to diagnose patients they haven't personally evaluated, saying it undermines the scientific rigor of the profession. Lee has avoided a diagnosis, saying instead that Trump shows signs of mental instability and dangerousness.

“We sometimes may have a duty to report, a duty to warn, or a duty to take steps to protect potential victims, including the public,” Lee said.

That mindset is part of what drives the working group. Members gathered in person last June and have been discussing their plans over the phone. They met again on Jan. 15 and plan to meet about every three weeks thereafter in Washington, D.C.

Presidential candidates since former President Ronald Reagan have released some of their medical records to the public. Medical information is highly confidential, and people who accesses or share it without patient consent are likely to lose their jobs and go to jail.

Candidates who are older are more likely to face scrutiny about their health. Trump and Sen. Elizabeth Warren, D-Mass., will be over the age of 70 at the time of the 2020 presidential election. Former Vice President Joe Biden and Sen. Bernie Sanders, I-Vt., have yet to declare their candidacies, but they also are septuagenarians.

Proponents of evaluating politicians for fitness point out that it’s commonplace in other jobs. Members of the military who handle nuclear weapons are assessed for mental fitness. Airline pilots and truck drivers need to be cleared, too.

“To have presidents, who have millions of lives in their hands, not be required to undergo a fitness for duty exam is just very anomalous,” Lee said.

Arthur Caplan, founding head of the Division of Medical Ethics at NYU School of Medicine, has for decades called for an independent medical panel to evaluate the president and candidates, but said he doesn't think efforts to create one will succeed. He believes only factors that could affect a person's ability to do the job of president should be disclosed, whether to the public or to a congressional committee.

Something trivial like a toe fungus wouldn’t need to be disclosed, nor would politically loaded issues, he said, such as whether someone had used drugs or whether a female candidate had an abortion.

“I don’t think the system is so hard to come up with,” Caplan said. “It’s just that politicians just don’t want to do it. It’s not lost in the details, it’s lost in the desire to have it happen.”

Caplan envisions something similar to what hospitals do when they evaluate company executives. Dr. Donald Hensrud, who works in Mayo Clinic's Executive Health Program in Rochester, Minn., said when someone is cleared in the program, Mayo sends "a very brief letter saying we uncovered no medical issues that would preclude that person from performing their duties." If they find something troublesome, they send a brief letter stating there was a medical situation that might interfere, and the patient decides how to disclose the details.

Sometimes, determining which ailments could get in the way of people doing their jobs are clear-cut, such as the diagnosis of a fatal illness. Other times, they are less so.

"It happens all the time," Hensrud said of considering which health issues would impact someone's job, such as a history of depression. At Mayo, a team of doctors and people in occupational medicine work together to make a determination, seeking input from specialists where needed, he said.

"We try and obtain objective data and expert opinion as much as we can to help the assessment," he said.

Presidents get medical exams from doctors employed by the White House, an arrangement that critics say provides an opportunity for a cover-up to keep someone in power. This has been the practice throughout history, whether hiding the heart attack of Dwight D. Eisenhower or the extent of the chronic pain John F. Kennedy faced.

Last year, the White House physician, Dr. Ronny Jackson, read the results of Trump's physical to the public and took questions from reporters. He said the president needed to lose weight but declared him “fit for duty.”

Members of the media openly second-guessed the results, and Jackson later faced questions about his credibility following rumors from anonymous sources who said he would get drunk on the job and was improperly prescribing medications to White House staff. Jackson, who had been nominated by Trump to lead the Department of Veterans Affairs, fiercely denied the accusations but eventually withdrew his name from consideration .

Trump's second medical exam as president is set for Friday. The White House hasn't pledged to hold a press conference afterward. If they do, it would likely be delivered by Dr. Sean Conley, the current White House doctor.

“I won’t be listening,” Caplan said.