Trust in medicine

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By Dr. Tim Millea
Catholic Health Care Today

Dr. Millea

One of the most important and basic human needs is the desire for security. To feel secure, one must have confidence in the people and institutions that provide support and protection. That confidence requires trust.  It is troubling that over the past several years, the trust that Americans hold for their national institutions has eroded significantly.  A Gallup Poll report from April 2024 reports that only 49% of Americans are confident in their government and national institutions, such as the military and the judicial system. That figure is lower than all other G7 countries: Canada, United Kingdom, Germany, France, Japan, and Italy.

Similar distrust is growing with the American health care system. A survey released in late 2022 by The Beryl Institute and Ipsos reported that 68% of Americans said their trust in healthcare declined over the preceding two years. Clearly, experiences from the COVID-19 pandemic had an impact on the responses from those surveyed, but those findings do not seem to be improving. The most common reason for the respondents’ assessment was their impression that the “healthcare system acts out of self-interest rather than mine as a patient.” What would rebuild their trust in healthcare? The top three answers were “getting care in a timely manner,” “listening to and treating people with respect,” and “providing transparency in pricing.”

Every level of the healthcare system is a target of these complaints. According to a recent Trilliant Health survey, doctors, nurses, hospitals, insurance companies, the CDC and FDA, and public health agencies are all less trustworthy than at any time in the past. In this age of advanced science and technology, we have tests and treatments that have improved the quality and length of our lives. Why then the distrust?  Given the survey respondents’ answers, the problem does not lie in the technology.  It seems to be the people using the technology — the doctors, nurses, and health care industry — who are losing the trust of their patients.  What can health care providers do to restore that trust, which is critically important to the care of every patient?

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Health care workers devote their careers to one of the most stressful environments in our society.  Over the past several years, concerns regarding “burnout” among them has received much attention and many are leaving their careers. That leaves a diminishing number of clinicians caring for an increasing number of patients. A growing degree of pressure in this environment is a significant contributor to a “de-humanization” in medicine, with patients feeling they are seen as diagnoses or problems and not as persons. This leads to distancing in the relationship between the patient and those caring for them. As is true with families and friendships, the weakening of interpersonal bonds causes respect and compassion between individuals to suffer. This was clear to even the most ancient of physicians, including Hippocrates, who emphasized that “Wherever the art of medicine is loved, there is also a love of humanity.” 

In a 2021 survey by healthcare consulting company Tebra, respondents were asked, “What do you want most from a healthcare provider?” The top answer, from two-thirds of respondents, was “a good listener.” When respect, attention and yes, love, for another is demonstrated, a basic component is to listen to them.  If the clinician is rushed due to expectations from their employer or their practice, they may limit activities that appear to be “non-clinical.”  Like listening.  As a result, while their efficiency improves, their patients’ confidence and trust decline.

Perhaps the journey back to a society where patients again trust those caring for them requires a simple formula. Patients will be happier if happier people provide their care. How can our overworked, over-pressured and burned-out clinicians be happy again? One answer may lie in this: According to the “Handbook of Religion and Health,” among all Americans, 43% of those who attend religious services at least weekly report being “very happy” while only 26% of those who never attend services report that level of happiness. Is it possible that health care providers with a foundation of faith will have more satisfying and trustworthy interactions with patients?

From a historical perspective, the Catholic Church’s role in American medicine has been critical. However, the growth of secular medicine over the past half-century has made faith-based patient care more difficult.  Fortunately, evidence is emerging of a resurgence in authentically Catholic care. Several medical schools based on Catholic principles are now graduating faith-filled young doctors, including Marian University, University of the Incarnate Word and, soon, Benedictine College. In years to come, they and other Catholic clinicians and hospitals have the potential to be the “new evangelists” in medicine and to restore the preeminence of Christ-centered health care that fully respects every life at every stage.

The importance of a fully caring and compassionate physician is as obvious now as it was thousands of years ago. The 38th chapter of the Book of Sirach emphasizes the qualities of a good physician: “Then give the doctor his place … you need him too.  For there are times when recovery is in his hands. He too prays to God that his diagnosis may be correct and his treatment bring about a cure.” Is there a better treatment plan than having God on your care team?

(Dr. Tim Millea is president of the St. Thomas Aquinas Medical Guild and a member of St. Paul the Apostle Parish in Davenport.)


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