Why Doctors Are Losing the Public’s Trust

We discussed this blog post, and more, with Dr. Girgis in a live #PWChat TweetChat at 3:00pm (ET) on November 30, 2017! 

 

In my mind, the doctor-patient relationship is sancrosanct. There is no relationship where the bond of trust should be so strong, outside of matrimony. As physicians, patients rely on us to help them make life-saving decisions. And we need patients to be honest with us so that we can give the highest quality medical advice. Yet, there has been an erosion in this relationship over recent years. Doctors are no longer held in such high esteem as they were decades ago. Even our own Commander-in-Chief, President Obama, alluded to the fact that doctors have financial incentive to do more surgeries. The public is losing their trust in us. They see us as driven for profit. They feel we don’t listen to their concerns anymore and don’t care what they want or need.

Why has the public lost trust in doctors?

♦  Third parties are often making decisions. For example, they dictate their own formularies, and we often have our hands tied as to what medications we can prescribe. I often have patients ask me for the “strong Stuff.” They don’t realize that doctors are limited in prescribing habits, and we are not withholding the Best medications. But, we are the ones in direct with the patient.

♦  Outlier doctors have been gaming the system. Most doctors truly put patients’ care first, before profit. But, there are a few who inappropriately use their medical degrees for profit. Just look at Dr. Oz trying to get rich promoting weight loss products with no proven benefit. These doctors make us all look bad.

♦  There are many mandates imposed on us that affect patient care. One example is meaningful use. Doctors now have to document many metrics, inputting data into our EHR systems, in order to meet requirements. Patients take this lack of eye-to-eye as a sign that we are more interested in their digital record than them. They feel we are no longer listening to them. They don’t realize that we don’t want to be doing this. It has been opposed on us from on high, and we will be penalized if we don’t.

♦  HMO’s have greatly cut reimbursements to doctors. In order for practices to stay afloat financially, we have to see more patients. We need to find more and more room to see these extra patients if we want to stay afloat. Patients feel this and take it as an indication that we are pushing them through for profit and don’t care about them.

♦  Media tends to portray doctors in a bad light. There are big stories about the pill mill doctors and those arrested for fraud or harassment. There are so many more amazing stories of heroic doctors around than the bad apples. But the press does not give them attention. People rather see the bad than the good. This too tends to paint us all in a negative light.

Medical diseases are becoming more complex, and people are living longer. There has never been a time where patients need to trust their doctors more. All doctors need to remember their oath and put the patient back in center focus. We all need to take a stand against those doctors who are abusing the system for their own gain. Patients need to learn that the vast majority us care about our patients and have their best interests in mind. We all need to become a team again. Patients need to regain our trust, and our profession needs to re-establish its integrity.

Originally posted in Nov. 2015

 

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Dr. Linda Girgis MD, FAAFP, is a family physician in South River, New Jersey. She holds board certification from the American Board of Family Medicine and is affiliated with St. Peter’s University Hospital and Raritan Bay Hospital. Dr. Girgis earned her medical degree from St. George’s University School of Medicine. She completed her internship and residency at Sacred Heart Hospital, through Temple University and she was recognized as intern of the year. Over the course of her practice, Dr. Girgis has continued to earn awards and recognition from her peers and a variety of industry bodies, including: Patients’ Choice Award, 2011-2012, Compassionate Doctor Recognition, 2011-2012. Dr. Girgis’ primary goal as a physician remains ensuring that each of her patients receives the highest available standard of medical care.

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  • I've had problems with my skin for about 10 years now. Initially, been prescribed with antibiotics. After I was done with them, the condition improved for some time, then it became worse. Solution from the doctor? More antibiotics. So I took them again... I've changed several doctors since then. Not a single one cared: no special tests, no monitoring, no alternative treatments (I know that they exist, well studied, and could be effective)... Antibiotics ruined my health. These doctors did.

  • I think that Dr. Girgis missed the mark on why many of us are angry with the medical profession. Sure some people are upset because of the doctor-patient relationship, but far more of us are angry because of the front end process in most clinics and doctor's offices. It is the clerical people and other non-doctors who convince the patients that the practice doesn't give a damn about them. The entire medical community needs customer service classes and FYI, the patient is the customer, not the insurance company.

    • Unfortunately, this is untrue. He who has the gold makes the rules. The patient gives their gold to a middle-man, who then dictates the terms of the transaction, that both you and your doctor have to follow. The middle-man simply makes your doctor the "bearer of bad news".

      As medicine has become almost exclusively insurance-based (and insurance companies are businesses, not health-care entities), it has been commoditized like all other business ventures.

      The only thing your insurance company cares about is paying the least amount possible for your care, before you drop them and go elsewhere.

      If my mechanic made all of his revenue off car-insurance only (oil changes, flat tires, everything), over time, it would become a bare-bones front-end for the delivery of a product called "car-care" (which your car insurance would buy wholesale, from the lowest bidder) and any "customer service" you would receive would be as bland and impersonal as that moniker suggests.

      To me, it's actually pretty impressive that healthcare still TRIES to deliver on customer service, even as the resources to provide it continue to diminish yearly.

  • I think the lack of widespread attention for doctors and other health professionals (aside from maybe psychotherapists) to care for their emotional well-being contributes, and professionals just get burnt out or compassion fatigue. I think it would be so hard to be a doctor and see so many people suffering. I've seen a number of health care professionals who were responsive and empathetic and whose recommendations I trust, but I've also seen a few who were rough and impatient or even rude, and I think if I didn't have the good experiences to balance it out I could've ended up with a bad impression myself.

  • Well as you can see there are several years worth of comments here. Count me as one of the thousands who really do not have anxiety . Dr's need to be barred from even saying that word . We are all tired of it and no one is buying it .
    I am one of the many who has been badly injured by a benzodiazapine. At 56 I don't really see any hope of a normal life anymore after weaning myself off of that poison you said was so safe .. Shocking how many medical professional prescribe something they apparently know nothing about . Given to me because, again , you also didn't believe I had a stomach ache that wasn't just anxiety until my gall bladder burst and I had very painful complications after - which was - again - anxiety .
    Is there ANYTHING you people believe ??
    I also don't care what or who you have seen , unless I have been bugging you for drugs that are opiates don't raise your voice to me again about pain meds. I didn't ask for any and I do not want any , you drugged me enough . IF treating people in pain with opiates has affected you that badly maybe it is you that needs counseling .
    This year I have been able to find no one in the MD category to eve help shepherd me through catastrophic benzo withdrawal that will likely last several years with permanent nervous system damage . I have been made fun of , yelled at , assaulted with a urinary catheter while being told that hospitals are for sick people not people like me . I had urinary retention in Benzo W/D and you want to deny that , drug test me , then flip me upside down and backwards on a tilt table to shove one in 2 times too big and claim that yet again I am only there to get high ??? WTF ??? There is a special place in hell for people like this .
    I see a gentle naturopath now who, surprise, knows more about the drug you damaged me with than you ever will be bothered to learn about . I am slowly getting well under her care and it requires no drugs but does involve medical support and an appt more than once every 8 months and 30 min or more of her time to monitor all the damage you did through errant prescribing and subsequent lack of attention . Dr's should be fully made accountable for what they do just like the rest of us.

    MD's and alot of NP's and even RN's no longer listen to us and/or they spend the entire visit arguing with us about our symptoms.

  • Quacks, Inc. So sick of idiotic people posing as medical doctors. I have decided to just forego any more medical care. All they do is push pills and useless medical testing. At age 79, I do not want blood tests or useless pharma. I am dropping out. The state where I live qualified me for Medicaid in addition to Medicare. I am better off without any of it because the worst in the field accept Medicaid. So when renewal comes up again for Medicaid, I am dropping out.

    • "Quacks, Inc. So sick of idiotic people posing as medical doctors."

      I've personally experienced that quacks are far more abundant in the billion dollar industry of "natural/alternative health". Make no mistake about it that it's an "industry" out to make a profit. People are duped all of the time into giving these types their hard earned money, especially people who suffer from cancer. An acupuncturist claimed that he "cured" an allergy doctor's allergies apparently boasting of his expertise as an attempt to convince me to see him. I wish I had him on tape. I later shared the incident to my allergist/doctor and she told me that she could get sued making a claim like that.

      I have some great doctors now who I appreciate. That's not to say that I haven't had poor experiences in the medical field. People/patients can always seek a second opinion, which sadly some people don't for whatever reason. Your health is your own personal responsibility. If you've had poor experiences it's understandable that you could feel frustration. I'd move on and try to find another doctor to partner with concerning your health and well being.

  • I Think if doctors will perform there work innocently then they will never feel the pressure.

  • Trust, of course, requires trustworthiness. Waning trust in the health system is partly a result of the sometimes well-founded public perception that its key players pursue profits at the expense of patients. (The United States is the only wealthy advanced nation that has not committed to universal health care.) But there are steps medical leaders and public health officials can take to show they deserve to be trusted. People’s trust depends fundamentally on three questions: Do you know what you’re doing? Will you tell me what you’re doing? Are you doing it to help me or help yourself?

  • I never had a negative opinion of doctors until I developed Epilepsy 23 years ago. OMG what a nightmare. They tell me not to get stressed but getting treatment is most stressful thing on the planet! I'm finally just using cannabis (in legal state) and been seizure free for 3 years. Just trying to get my meds refilled was a nightmare. They were over $400.00 a month for one drug that had a zillion side effects that were $45.00 in Canada. I then found out Neurologist was getting free educations for his kids and lavish vacations from the pharma company to push this drug on patients when there were so many cheaper, better options. I'm like nope...sorry. I even had a doctor in Utah tell me to pray away my Epilepsy and another one that tapped my knee with a hammer and that was it...what year are we in 1410?

  • Doctors are loosing everyone’s trust because it’s honestly how much money can I squeeze out of this patient as possible from the very start. I’ll go in an office and before anyone even talks to me I get asked for a x-ray or mri before even getting looked at. It seems like every place I have been to is a pump and dump, bait and switch business. After they suck you dry they start acting super arrogant to the point you get upset and don’t come back then go somewhere else and have to start over. Plastic surgery is the WORST. I never wanted to enter a plastic surgeons office but I had an old broke nose I wanted fixed and got referred by a ent specialist to go to a guy in Austin. From what should have been covered by my insurance he managed to get 8000$ cash, witch I didn’t care too much about because I really wanted to fixed. The doctor did everything possible on the menu beside fix the break in my nose and gutted out my face for everything the insurance company would pay him for. I have never had to deal with such evil and lack of compassion for human life. This was in Texas and I never consisted to any of that. I had to sue the guy but the damn tort laws now make it to where the doctor basically has to kill you to get anything and the compensation will hardly cover the funeral after legal fee and litigation. It’s a sad world we live in where doctors are getting paid to basically try and ruin your life and health. That’s why so many holistic doctors are getting killed because you can crue anything with fasting and organic, plant based food. It’s a matter of time before everyone wakes up and sees what’s going on. The further you stay away from doctors and hospitals the better off the world is. Every time I’ve been to the hospital that charges your insurance 7$ for an alcohol pad it seem the food the the most unhealthy thing you could have, and of course all the sugar filled drinks you want. They are out to keep you as sick as possible without killing you right away so you have to stay close. At least doctors should recommed a natural option along side of the poison they pump or recommend some other options beside cut out important organs of your body for a buck. I was just reading a sleep specialists yelp and saw he’s getting paid to shoot acid into the back or people’s mouth to remove there uvula, THIS IS INSANE! If you work a busy calendar and make to do the appointment and get help and they put you on the spot for that and you agree to it than you have to live with an amputated part of your body forever. I’ve never been more lied to and treated more horribly than with doctors.

  • My experience in the past decade is that about 90% of the Drs don't care (whatever the reason is). I've had a number of symptoms I've been trying to get figured out. Generally just yields the PCP to do a physical and CBC and that's where it ends.

    The last GI I had for my digestive issue pretty much conformed IBS (Mostly bloating and cramps)+Dysphagia+Haital Hernia+Ventral Hernia. And said all he could do is give me Nexium that I would have to take for the rest of my life. And when the prescription ran out and they sent a request to his office, they never sent a new prescription. A year later, another try with a new GI. She decides to take an endoscopy and on discharge the preliminary findings didn't even mention the hernias. They took biopsies which would take about 2 weeks. It's been a month and I havn't heard back. I've requested an appointment but already have a good idea of the outcome.

    This is an example of my medical experience over the past 10 years. My symptoms get worse year-to-year yet there seems to be no concern whatsoever from the medical professionals. I'm at the point where I have pretty much given up on medical professionals and unfortunately, it's not like I can prescribe my own tests and eliminate probably causes. Guess it's too hard to expect someone to do their job.

    In my case, I also wonder how much of the lack of care also comes from a bias due to the fact I have Bipolar 2. Lately, I've started wondering if treatment would be different if I simply didn't indicate my diagnosis and medications on my history for new doctors. Yeah, i'm at that point!

    Doctors, if you don't like your job, I understand. Lots of people went down that path because that's "where the money was" (I am a software engineer, so it was pretty much the same when I graduated) and aren't cut for it and possibly many that didn't realize the demand, drain and work conditions. But also, if you aren't liking your job and are struggling to do the work... Move aside and stop screwing with patient's lives!

    I'm only a few doctor visits away from being done for good!

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