NY Times 4/24/24, D Lamas: Skepticism Is Healthy, but in Medicine, It Can Be Dangerous
This commentary starts with a sad anecdote about a physician trying to navigate a difficult end of life decision and transitions to a discussion of public trust in medicine.
A few excerpts:
We are at a crossroads in medicine when it comes to public trust. After a pandemic that twisted science for political gain, it is not surprising that confidence in medicine is eroding. In fact, trust in medical scientists has fallen to its lowest levels since January 2019...
But our medical system relies on trust — in face-to-face meetings as well as public health bulletins. Distrust can lead doctors to burnout and can encourage avoidable negative outcomes for our patients. This is partly what is driving increasing rates of measles among unvaccinated children, failure to follow recommended cancer screening and refusal to take lifesaving preventive medications. There are no easy solutions here. But if we do not find ways to restore and strengthen trust with our patients, more lives will be lost.…
When that skepticism shifts into abject and irreparable disbelief, we see some patients make dangerous decisions…Trust can sometimes be repaired by clearly presenting facts and figures, but it is about more than explaining numbers…
Many of our patients started their medical journeys wanting to believe in their doctors. But then the medical system that they wanted to trust failed them, in small ways and large, from haphazardly rescheduled appointments to real medical error…
For her patient and family facing an end of life decision, “they left without a word, carrying with them his bags of belongings and —I can only hope — faith that we had done the best we could.”
My take: Trying to understand distrust and navigate hostility is one of the most difficult challenges that physicians face. It is difficult to witness patients and families make decisions or omissions in care that lead to worsened outcomes.
Related blog posts:
Humor: Skepticism with Scooby-Doo Can Be Dangerous Too (& funny) -last week’s SNL Scooby-Doo skit
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