Trust in doctors and hospitals decreased significantly following COVID-19, a new study has found.
Trust in doctors and hospitals dropped by about 31 percentage points between April 2020 and January 2024, from 71.5 percent to 40.1 percent. The decrease was noted across all sociodemographic groups. Adults who were vaccinated or received COVID-19 boosters were more likely to say they trust physicians and hospital systems.
The “non-probability internet survey” published by JAMA Network on July 31 was based on data from 443,455 respondents questioned in “waves” by multiple recruitment vendors and overseen by the COVID States Project, an organization formed early in the pandemic to measure public attitudes.
The study authors say their main concern is the public’s hesitation to receive vaccinations. The writers note their survey has limitations, such as trust being “a complex construct.”
“Despite these caveats, this multiwave nationally representative survey identifies a substantial decrease in trust in physicians and hospitals during the COVID-19 pandemic and demonstrates associations between trust and health-related behavior after accounting for a host of potential confounding variables,” the authors write. “Whether interventions to restore trust could increase compliance with vaccination and other positive health behaviors merits further investigation.”
Trust Plummeted Pre-COVID
The loss of trust began long before the pandemic, and the survey results are not surprising, says Twila Brase, co-founder and president of the Citizens’ Council for Health Freedom (CCHF).
“The drop in trust of doctors and hospitals demonstrates a growing concern that American medicine is no longer on a patient-centered mission,” said Brase.
“Covid exposed the enormous influence of outsiders over treatment decisions,” said Brase. “Patients were trapped in medical facilities that followed the Covid narrative, not good medicine.”
During COVID, families ran into conflict with hospitals over treatment. Doctors refused to give readily accessible lifesaving medicine and pushed dangerous experimental vaccines with no regard for personal rights, patient preference, or objective reality, says Brase.
Interference by Payers, Govt.
Also contributing to growing mistrust are financial conflicts of interest and government meddling in treatment decisions, says Chad Savage, M.D., the founder of YourChoice Direct Care.
“Insurance companies and the government have become so deeply intertwined with the provision of care that these entities often dictate the pace at which doctors see patients, the tests they can order, and the treatments they can prescribe, diminishing the doctor’s role,” said Savage.
“This is highly detrimental because a patient’s adherence to treatment protocols is closely linked to the trust they have in their physician.”
The meddling can impact treatment compliance. “When patients don’t understand the reasons behind their treatment plans, they are less likely to follow them,” said Savage. “If given sufficient time, doctors can more thoroughly explain their reasoning, thereby improving patient compliance.”
Corporate, Government Takeovers
More than 70 percent of U.S. physicians are now employed by corporations and paid government-established prices, says Brase.
“Most doctors are not working for patients today, despite their best attempts,” said Brase. “They are working for corporations and government agencies who’ve set the criteria, the treatment protocols, the quotas, and the payment incentives. Patients have good reason not to fully trust their doctors or their hospitals.”
In addition to corporate and government controls, insurance companies also weigh in on physicians’ performance.
“Doctors may be rated based on their ability to defend insurance companies’ coffers instead of the patient’s best interests,” said Savage. “For instance, doctors may receive higher compensation by denying expensive tests like MRIs, potentially putting their self-interest in conflict with the patient’s best interest. Such conflicts of interest should have no place in the medical system.”
Hurried Pace
Prescription drug use has increased exponentially in recent years, trending up over time to today’s historic highs, according to a 2023 report published in PubMed.
Abbreviated care visits incentivized by the third-party system have led to greater pharmaceutical prescribing, and time-constrained physicians may see prescribing medication as the quickest route to the next exam room, rather than focusing on the more time-consuming task of lifestyle modification, says Savage.
“This excessive prescribing feeds into the perception that physicians are in collusion with pharmaceutical companies, when in reality they may simply be rushed, overwhelmed by the demands of a bureaucratized healthcare system,” said Savage.
Patients notice they are being rushed, says Hal Scherz, M.D., a manager partner of Georgia Urology.
“[Patients] are unhappy with the lack of time that doctors spend with them,” said Scherz. “They are rushing through visits because they’ve got to make [employee-mandated] quotas. People are concerned whether or not doctors are working for them or working for somebody else.”
Patients Appreciate Independence
Georgia Urology, the largest privately owned urology group in the country, employs 55 doctors and 30 advanced practice providers in 30 locations. Scherz’s top-rated practice is completely physician-owned and -operated, not connected with any university, hospital system, or private equity group. This freedom of practice has resulted in continued growth and success, says Scherz.
“We have tried to create a model that is sustainable so that we can withstand what’s going on in health care,” said Scherz. “I think we’ve been really successful in doing so.”
Distrust of physicians outside his own practice and in hospitals is a concern Scherz says he hears regularly from patients.
“The waits for appointments are very long; it’s very difficult to get in to see doctors, especially specialists; the testing that gets done in hospitals is far more expensive than in independent, freestanding centers; the nursing shortage is acute; just the whole experience is somewhat less than ideal for the patients,” Scherz said. “They don’t feel that their needs are being met.”
CCHF calls their solution The Wedge of Health Freedom, which would move all care and coverage back to “freedom, affordability, privacy, compassion, ethical care, charitability, and patient-centeredness.”
“Patients desperately need doctors and hospitals who work for them and who do not harm or exploit them to meet the goals of others,” said Brase.
Ashley Bateman (bateman.ae@googlemail.com) writes from Virginia.