Today, public confidence in the U.S. health care system is low, with only 23% expressing a great deal or quite a lot of confidence in the system (Gallup 2014). The United States is tied for 24th place in terms of the proportion of adults who agree with the statement, “All things considered, doctors in [your country] can be trusted.”
There are many reasons why that might be the case, but doctors, in part , are to blame. Specifically:
1. The foundation of medicine and one of the basic ethical tenants is that the doctor will place the interests of the patient above their own or any other secondary interest. Whether perception or reality, patients no longer believe it.
2. Patients are taking on more financial responsibility for their care and they feel isolated and confused when dealing with the sick care system. When they call "tech support", no one gives them a straight answer or even picks up the phone.
3. Doctors are scapegoats for others who game the system and concentrate wealth, power and influence.
4. Patients are confused by conflicting, difficult to understand clinical guidelines
5. Increasing income inequality makes doctors targets out of resentment
6. There is a general lack of public trust in business, organizations,government and other societal institutions.
7. The 24 hour news cycle emphasizes bad news and highlights medical price gouging and those who commit fraud and abuse
8. Medical societies and their leadership have failed in their missions of advocacy, instead being perceived as self serving and opportunistic
9. Patients are scared about the rapid pace of change and disruptions in the doctor-patient relationship
10. There has been a fundamental failure to resolve the ethics of medicine with the ethics of business and patients fear physician entrepreneurs.
Like it or not, US doctors practice the business of medicine as much as the art of medicine. Unfortunately, one seems to have eclipsed the other in the minds of patients and that has eroded trust. Once broken, trust is difficult if not impossible to restore and the results will impact whether and how patients respond to their doctor's recommendations. In the end, that's not good. Trust me.
Arlen Meyers, MD, MBA is the President and CEO of the Society of Physician Entrepreneurs at www.sopenet.org