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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  • Perhaps most concerning is evidence that low levels of trust can weaken the ability of governments and public health agencies to respond to epidemics. A recent study suggests that Ebola spread more widely and persisted longer than it otherwise would have if there were higher levels of institutional trust.

  • Doctors are absolutely untrustworthy. They are paid piecemeal by the procedure, and they feather their nests by doing unnecessary things. For example: Some years ago I had a colonoscopy at a teaching hospital. My colon was absolutely pristine from entry to the end.
    When they were almost completely done with the procedure, the attending physician proclaimed, "Take a biopsy!"
    The medical student said, "What?"
    The attending replied, "There, there."
    Next thing you know, the attending had gouged a sample out of completely pristine uniform tissue.
    He had decided to increase the cost of the procedure by doing an unnecessary biopsy. . .
    Amazing. He didn't even care that he had students witness his perfidy.
    I had refused to take the mind numbing drugs, so I know what happened with complete clarity.

  • Every excuse given here is just a cop out.

    No one is forcing anyone to not care for patients. That is almost every doctors response to the pressure being put on them.

    Furthermore, these excuses are only touching the tip of the problem. The issue is that we now have all the information in the world at the tips of our fingers and people now know that doctors are not physicians anymore. Doctors are nothing more than technicians following a scripted protocol for just about everything. To top it off the protocol is a joke. It is symptom treatment with out ever getting to the actual problem. Medical “science” no longer exists. It is now the goal of pharmaceutical companies(the same ones who own every guideline to come out of the cdc via bought “doctors” on the board) to get as many people on pills for as long as possible. If you think otherwise you’re an idiot.

    The cherry on all of this is the ego and superiority complex of this technicians who think they understand any of this.

    Why do you think we have 1000 different conditions with no known cause and no known cure?!?! They’re made up and they are clusters of symptoms being called a disease or a condition instead of people figuring out the root cause of all of it. Take a look at the findings of several scientists and doctors with studies proving Lyme disease is the cause of many autoimmune disorders that we can’t explain. Yet, the CDC says it doesn’t exist. Why? You can also find that the same board of doctors who writes the guidelines for Lyme disease and treatment also had 2/3 of its members holding patents for those same treatments and tests....

    Did you read that?!

    The CDC is lying and covering up a major health concern that is highly communicable and causing things like dementia/Alzheimer’s, als, ms, adhd, autism and more, just so a few old rich men can make millions of dollars.

    This is why doctors aren’t trusted. You’re intelligent idiots who are following a script written by crooks instead of actually practicing medicine. And instead of doing something different, you want to write excuses about how someone is forcing you to do this.

  • We have comprehensive health programs which includes full body health check ups at various places in Bangalore, Pune

  • the problem is totally that doctors are gaming the system they are running up bills with the insurance company if you get an infectious disease or anything that is serious they want to run you through their circle of friends until your insurance company has paid out every last dollar for the year and then they don't want to diagnose you because they don't want to be sued for their negligence that they have been committing draining the insurance companies dry that's why the insurance companies are fighting back. It becomes a game between the doctor & you! the doctor is saying what is your life worth? Will you keep coming back all year long and letting me run you through my circle of friends to drain your insurance company and then you're still not going to get a damn thing from us! now go away we've got your money!

  • After many years of reading about and participating in the U.S. medical industry, I would argue that the public has lost trust in THAT, not specifically doctors. Unfortunately doctors are just the public face of a system that has as it's number one priority making money - not creating and sustaining true health. From what I understand, the "research" that we hear so much about is generally funded in large part by chemical and pharmaceutical companies. That funding not only dictates how much money universities receive but influences the eventual findings about how safe or effective we are told the drug under study is. Look for example at a handful of studies for commonly used medications (i.e., beta blockers), scroll down to the bottom for the conflict of interest statement, and you will see a list of contributors from the prescription drug industry. These same universities are training the conventional medical doctor that you take your family to see. That training involves very little classroom time centered around nutrition. One doctor I spoke with told me that she received ONE class in nutrition in her entire time in medical school. The class she did take espoused nutrition information influenced by the very same faulty research I mentioned earlier as well as plenty of questionable recommendations from governmental bodies like the FDA and USDA - both influenced by the agricultural industry and lobbyists. Add to that doctors getting kickbacks and incentives from pharmaceutical reps and device manufacturers, and it is a wonder we are in as good health as we are. I know several doctors, and they are genuinely good people who want to help - and I'd like to think that is the majority - I suspect that many of them are being lied to as much as we are. As a patient, you have to do your own research, ask your doctor questions and don't assume that they are smarter than you. Read books, scour blogs, and talk to other people that are in your same situation. Find a doctor that has either had training in functional or integrative medicine, and even then don't take anything they say at face value. It is only when enough people understand how badly we are being scammed and how sick we are being made in the name of profit that things will change.

  • I can’t speak for anyone else but these are the reasons I lost trust in doctors.

    1) your first solution to everything is to drug people. Rather then figure out what’s causing the pain and figuring out house to fix it. You’d rather take the short cut and mask the pain with an opioid. Then you wonder why America has such a drug problem.

    2) you overprescribe and glorify non steroidal anti inflammatory drugs. Medicines like Ibuprofen, Tylenol, and naproxen are great if used once in a while to get rid of a headache, they should not be taken long term, or in such high doses as you prescribe. It causes liver damage, and heart complications, stroke, high blood pressure, stomach ulcers, respiratory complications.

    3) you’re are arrogant. They must teach narcissism 101 at medical school. You all believe that your so smart in reality your supporting staff is smarter and more professional then you’ll ever be. Respect to all the nurse practitioners, medical assistant’s, and patient care aids.

    4) It is too easy to offend you by asking you a question. You constantly think that everything we say is questioning your intelligence when really they are just questions to sate our curiosity, or worries.

    5) you accuse people entirely too much of being drug seekers. You demand that you patients trust you, but you treat them with nothing but suspicion. There are other reasons why a patent comes you your office complaining about pain, or seeming loopy. Your job is to figure out what’s causing the pain, not assume they are all junkies. Even if the evidence points to drug use it might not always be what’s going on. For example. My PCP noticed that my liver enzymes were high. He assumed I was on drugs. Turned out I had a fat liver caused by my diet.

    6) you are too expensive for people who have crappy insurance, or no insurance at all. Complain about trying to keep your head above water but I’ve seen the houses you live in and the cars you drive. You are far from the days when doctors were payed unfair wages. The people you are gouging for money only make a fraction of what you make. You try to justify it by saying that insurance should pay for it but that’s why everyone’s insurance premiums are so damn high.

    7) we also don’t trust doctors because you are rude. We don’t mind so much that you don’t make eye when your talking to us although that is rude. You show up after all the work is done by your supporting staff, and spend a maximum of fifteen minutes with your patient. You alway talk to us in the most condescending tone, yet somehow don’t fully explain what’s going on in our bodies.

    8) you are so busy trying to push people out the door to bring more in. You are 100% profit driven, and when you honestly don’t care we know. You might not think it shows because we don’t say anything, but we notice.

    The media doesn’t demonize you. You do that to yourselves by causing harm to people when you get careless. It’s not the patients fault doctors have a bad rep. It’s not that they don’t understand that you’re watching the monitors. It’s because we know that you really could care less either way. We can sense the emotionless lack of empathy you possess. We know when you’re just going through the motions, and not putting yourself in your patients shoes. Medical practitioners have lost their sole.

    I’m not saying all doctors are like this. I’m saying that it’s rare to find a doctor who isn’t. When you pursue a career because of its money and popularity, but have no real passion for it then that’s when you become miserable, and just go threw the motions of what med school thought you. You become one of these doctors.

    • While I think some of your comments are over the top, there is considerable truth in what you say. There is a tremendous amount of bs and pretending in the world medicine (pretending to care, pretending to be doing your best, pretending to know what your talking about when you don't...) and a lot of broken promises. I've seen enough to be able to point to the number one root cause of the problem: dishonesty. Money unquestionably plays a far far bigger role in medicine than it used to, or than it should, or than the powers that be want to admit (because it makes them look bad and greedy which they are), and the dishonesty comes in when the system claims that they have the best interest of patients in mind when in fact it does not. Think it through and you will see that is the reality. I can assure you that if greed did not taint the process, then the system would be set up entirely differently. Unfortunately, I do not know how to have a system that works at all without money being the bottom line motivator in our current society. Society has to change, and a completely different set of values needs to be instilled in the worlds (particularly the United States) inhabitants to make it better. I don't know how to do that. It takes a kind of moral courage that simple does not exist anymore.

  • Doctors have pretty much destroyed my faith in humanity. I am 36, have multiple physical disabilities, arthritis, IBS, and nerve issues. I am not on any kind of medication. I am told to suffer. I am told "your MRI shows everything is normal." I then go pick up a copy of my MRI report and it shows advanced arthritis. I go to a different doctor, I'm told to suffer. It's just an endless cycle of being told to suffer or referred to other providers that takes my money but never does anything for me other than say, "you''re young for having arthritis!!!" It's like yeah, that's why I am here. Then told to just suffer. Struggle working full time, my employer is willing to accommodate and has told me this. They have told me just need doctor to write up what would help. Go back to doctor, "I don't feel like filling out paperwork, go suffer some more." After 10 years of this, I am about to call it quits on life. Family members and co-workers mock and make fun of me for how I work. I'm just sick of existing, suffering and never having a life.

    • I'm really really sorry you're going through his, my thoughts and prayers are with you. You need to cut out whoever is mocking you ASAP, they don't deserve to be your family. Furthermore, I don't know if you've heard of it or not, but reddit.com may have a community that has people with your same issues. There should be a search bar, once you have entered the specific community, search up what people have done to cure or to manage their symptoms.

    • I'm getting the same damn response from doctors I've been begging to help me. I have 4 herniated discs in low back and 3 in my neck. I was injured serving a tour in Iraq. I was given oxycodone and muscle relaxers and told to go back on patrol. Then, I get hit by an IED, which fractured my spine in 2 different locations, tailbone and L5. Transported to Germany for surgery then Walter Reed for 8 months till I could walk again. I rotate to civilian life and able to resume as police officer. In November 2014 I was shot in line of duty in Ferguson during riots. Doctors tell me I'm fine everything normal....really? I'm in miserable pain earlier today my blood pressure was 181/101. My doctor didn't even care that my blood pressure was at critical rate. I explained fully to her how much pain I was in. I'm told I don't have enough reason to have relief in this modern time with the advances in medical procedures and medications that are available. Tell me what to do. I have been ground up and I don't need pills to losen my bowels or pills to sleep or depression pills. I need pain relief. What the hell do I need to explain to her who is a pain doctor, to help me? I feel she's racist against white police officers and I would love to prove it. Because, with all the injuries I have documented and she tells me I'm normal and there's nothing she can see what's wrong with my spine. My MRI report shows a laundry list of hardware and deformities from trauma. She must have been reading another patients report.

      • I truly understand although not gone through what you did,
        . A doctor did this to me and worked my way back after being on crutches for 3 years. After 25 years I’ve continued walking, riding a bike but now no pain meds what so ever for I was told that I was going on the latest greatest and body doesn’t metabolize it but won’t put me back on what let me live a life. Now I lost my mom who shouldn’t have suffered so bad wasn’t even on hospice and someone was there the week before she died and she was told keep moving. You know how hard it is to keep moving when you hurt and instead she dies. Now I have this to look forward to really. Now they wonder why people are losing their trust in the medical field. I can’t write much more for it hurts but will keep you in my prayers.

  • doctor would have the exam with me, and then sit in her office for a half hour to bring up issues that could not be talked about with the exam going on. My latest doc has some man come into the exam room and while she’s doing a pelvic, the guy busy scribing. Am I going to bring up something personal about my sex life with him typing away? Not on your life and so it is literally in-out-and-done. Wham-bam-thank-you-maam. And off she waltz with her aide de camp to inflict her next annual exam on the next body.

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