Why Do People Distrust Doctors? February 18, 2023

Why do people distrust doctors? I’m not talking about all people. But a lot of people. And it’s growing. I have been practicing medicine for about 20 years now. I’ve practiced in the upper Midwest, the southwest, and now the mid south region of the U.S. And I’ve talked to a lot of people over those years. My perception is that people are generally starting to distrust us as a profession of doctors, much more than in years past. 

What is my answer to that?

 It’s about time! 

I’m not trying to throw all of the medical profession (including myself) under the bus here, but think about it…As a patient, you come to us in your most vulnerable hour. You hurt. You can’t breathe. You are scared of something terrible that will happen to you. You’re anxious. You’re depressed. You have researched your symptoms or your fears and they have indeed been confirmed by Dr. Google. You come to us in your desperate, vulnerable hour. In a way, you must be able to trust us. Who else are you going to turn to? 

You seek advice and we give opinions based on a multitude of different backgrounds. Some of us tell you the same opinion that someone told us many years ago in med school. Some of us tell you what you want to hear and not what we know is best. Some of us defer to consensus statements from agencies like The American Medical Association or the Center for Disease Control, of the American Diabetes Association or the American Heart Association, or drug reps. Some of us dig deep–really deep–until we get to the bare bones of the issue to form our own evidence based answers, in order to avoid biased advice. 

Yet as a profession, we have managed to erode that trust when we polarize a medical situation to fit our own political narrative. And this erosion is accelerating. I believe this boils down to a few things: 

1. If a patient is going to come to a doctor in their most vulnerable hour, they want a doctor who understands and connects with them on a deeper level, whether it be the same gender, religion, political affiliation, language, or culture. The problem with this is that the doctor may have a built in bias that may confirm what the patient already expects to hear. Is that good medicine? 
2. Too many doctors pose as experts in their field without actually having any training at all in other fields that may directly, or indirectly affect their ability to “expertly” manage their patient. For example, a cardiologist may keep their patient from dying from a heart attack by prescribing a blood thinner that causes internal bleeding and kills the patient. End result: The patient is still dead. Just not from a heart attack. 
3. Not enough of us stop and take a look at potential biases that we have. The largest one that affects just about everyone is called confirmation bias. We only see what we only look for. This happens in every field of science. And when others don’t see what we see, then they must be the idiots here, not me! I certainly can’t be wrong. Can’t you see the results that show how right I am and how wrong they are? This tribalism in medicine is killing our reputation. 
4. We are corporatizing our relationship with our patients. The patient encounter is becoming a transaction devoid of emotion, feeling, or empathy in order to get more patients through and monetizing everything we can. Corporations are great for banks, hotels, and newspapers. They suck at treating people in their most vulnerable moments of life. 
5. We tend to be really bad at admitting when we screwed up. People remember these things. How can you keep trusting in a medical  institution that doesn’t acknowledge their failures in a way that builds trust? Especially after telling you not to trust others who disagree with them, but it turns out that he/she was wrong and the other party was right? COVID exposed this on a massive scale. Major governmental institutions, medical groups, and medical experts were just plain wrong on several pronouncements. But they won’t fess up to it, and won’t change their ways. Guess what? People aren’t going to trust you anymore. And they shouldn’t. 

The only way to start gaining trust in patients again is for doctors to try really hard, every day, to look at the positions of those who think differently than they do. Why does this patient think that ozone therapy or light therapy or herbal therapy works? Maybe there might be something to it? Maybe ivermectin works in a subset of patients with COVID? Maybe the COVID vaccine actually does save lives in the elderly. Maybe natural immunity does work as well as the vaccine, maybe even better? Maybe lockdowns of nursing homes were effective but not locking down elementary schools? 

Maybe humility needs to be our mantra if we want to keep patients trusting us. Maybe.