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Trust Me, I’m a Doctor: When did we lose the public’s trust?
“Trust me, I’m a doctor.” This used to be a line that was commonly used, as doctors (physicians) were generally trusted by the public because of their advanced education, as well as their moral and ethical code. Over the years it appears that the public has progressively lost more and more trust in physicians. So why is this? Well as a physician, I have several theories:
A doctor is not always a physician. Physicians are MDs or DOs, intelligent people who have completed four years of medical school, and typically 3 to 5 years of additional residency training to show that they are proficient to see patients on their own as a physician or surgeon. That said, there are several fields where they are able to call themselves “Doctor“, but they are not physicians. These include, but are not limited to, chiropractors, doctors of nurse practitioner, doctors of physical therapy, psychologists, PhD‘s, even lawyers have a doctor of jurisprudence. While many of these professionals are very skilled at what they do, and while many of them responsibly use the term doctor, some use the ability of being called doctor to masquerade as a physician. If you are on an airplane and someone starts having a heart attack, and overhead you hear “is there a doctor on this plane?!“, And someone stands up and says “I’m a doctor!“, and it turns out they are a PhD in botany, wouldn’t you feel deceived as a trusting member of the public? All of these individuals have had to work hard at varying levels to achieve their appropriate title, but in the same sense, humility of their abilities, recognition of what it takes to become a physician, and knowing their role in regards to the healthcare system, are all critical when someone is under the impression that they are seeing a physician.
Another reason that many people don’t trust their physicians anymore is they feel their physicians don’t care about them. Is this a lack of caring, or is it a lack of time afforded to the physician to be able to spend an appropriate amount of time with their patient to get to know them, figure out what is going on with them, and deliver a treatment plan the patient understands? Part of the broken system of medicine, another blog I have already spoken about, is most physicians are employed by a hospital system or a corporation. Medicine is no longer treated by these corporations as an art, but as a business. To these corporations and executives, individuals aren’t patients, but customers. Doctors are incentivized not by outcomes, but by numbers, seeing as many patients as possible and in as short of time as possible. So many of the physicians, who went to medical school because they were altruistic individuals that wanted to help people, have an inability to do so in their setting because of the system they are working in. This factor was one of the main reasons that drove me to leave this system of medicine and start my own practice, outside of the insurance and hospital systems; so that I could provide the best care for my patients, and instill their trust in me.
A big reason I feel the public has lost their trust in physicians is the internet, and notably social media. It seems that people trust influencers, people who are charismatic about conveying their opinion as fact, but they are not getting it from validated sources. There is a phenomenon known as the Dunning-Kruger effect. The Dunning–Kruger effect is a hypothetical cognitive bias stating that people with low ability at a task overestimate their own ability, and that people with high ability at a task underestimate their own ability. So some of these Internet personalities feel that they are an expert on the topic, while they are very much a novice.
Part of becoming a physician is I had to learn how to learn. I had to learn how to comb through the evidence, learn where to find answers, learn when further evaluation is necessary, and most importantly, I had to learn humility, to know what I don’t know. Many individuals who masquerade as physicians, but are not a MD or DO, assume they know more than they know. Part of the problem is their schools of education put grandiose ideas into their head, stating they are just as good as a physician, they can do anything that a physician can do. They are not engraining them with the humility that physicians obtain through their years of training , practice, knowledge acquisition, and supervision until they can progressively be let go to see patients autonomously.
Did you know that while physicians are completing their four years of medical school, and 3 to 5 years of residency, this typically amounts to anywhere between 12 to 18,000 hours of supervised education before they are allowed to see patients independently on their own?! Additionally, many physicians complete additional training, known as fellowships, on top of that. I personally completed two separate one-year fellowships, one in osteopathic manipulative medicine, one in primary care sports medicine, so you can add those additional hours of supervised training to that list.
While there’s a lot you can learn from the internet, the source can’t always be trusted, the context is not always appropriate, and the application of this declarative knowledge is not always applied appropriately procedurally. Understand that as a physician, I have learned how to learn the right things, learned how to critique and properly use the research and evidence, and finally I have learned how to apply it in the clinical setting so I can offer the best and safest treatments for my patients. So it is fine to question your physician, but please, trust their answers.
Trust me, I’m a doctor.
