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    The eroding trust between patients and physicians

    For decades, physicians were among the most respected professionals in the United States. But that’s changing.

    Patients’ trust in their doctors and healthcare in general is declining and the consequences go beyond physicians’ lowered status. A lack of trust can lead to decreased patient compliance, worse outcomes, corrosive physician-patient interactions, and physician burnout.This article appears in the 4/10/18 issue of Medical Economics.

    “The physician-patient relationship has taken a major hit over the years and the connection is much less than it used to be,” says Andrew Morris-Singer, MD, an internist and president of Primary Care Progress, an organization working to improve primary care. “We have to reimagine the relationship. It has to evolve because the current relationship isn’t working.”


    Eroding trust

    In 1966, 73 percent of Americans said they had great confidence in the leaders of the medical profession. In 2012, only 34 percent felt the same way, according to a 2014 study published in the New England Journal of Medicine. Similarly, in a 2017 SERMO survey, 87 percent of U.S. physicians said patients trust their doctors less than they did 10 years ago.  

    Healthcare is not the only institution suffering from an erosion of trust. Organized religion, government, media, law enforcement, the financial system, higher education, and almost every other pillar of society is as well. Social scientists have attributed this to everything from higher levels of education, the spread of the internet, and failures of the institutions themselves.

    Healthcare, once regarded as a bastion of altruism and incorruptibility, has been revealed to be as imperfect as any other institution. Thanks to the fights over the Affordable Care Act, proposals to cut Medicare and Medicaid and the push for universal coverage, healthcare has become a highly controversial issue for providers and patients alike. Healthcare systems, insurers and professional organizations like the American Medical Association have all been accused of acting out of self-interest, rather than in the best interest of patients.


    HOT TOPIC: Physicians face punishment for speaking out against non-physician care


    In addition, patients now have access to information that makes it easier for them to second-guess their physicians. The internet allows them to do their own research and arrive at their own diagnoses and treatments, correct or not. As a result, fewer patients defer to physicians without question and, if their information conflicts with their doctors’ views, they might be less likely to trust their doctors.

    Finally, physicians sometimes suffer for the sins of the entire industry. When an insurer declines to pay for a procedure or hikes the co-pay for an office visit, it’s often the physician who delivers the bad news to the patient, which can damage the relationship between them.

    Next: Why trust matters


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