America is Dying: A growing distrust

The story of Christopher Duntch, known as Dr. Death, is unnerving. As a neurosurgeon in the Dallas area, Duntch botched dozens of surgeries, leaving his patients paralyzed, in pain and even dead.Scalpel in hand and with absolutely no signs of remorse, this man continued to practice for years despite seriously injuring 31 human beings, with two others dying from surgical complications. Case after case was a disaster, but still no legal action was taken. Finally, in 2015, a grand jury indicted Duntch for multiple counts of aggravated assault and one count of harming an elderly person. Now, Duntch sits in jail serving a life sentence for his abominable acts.

Of course, this is one very extreme example. But upon listening to Wondery’s podcast, which spotlights the entire scenario in a series titled, “Dr. Death” (2018), I began to question how much faith we put into the people that take care of us. Once, Duntch even cut a patient’s vocal cords, leaving her permanently voiceless. Our healthcare system failed to protect Duntch’s patients in so many ways, so this made me wonder: how much are we really trusting the people with the medical degrees?

Well, as it turns out, there is actually a growing distrust among Americans towards the healthcare system. According to an article by The New York Times, only 34% of Americans have confidence in medical personnel compared to the 75% of people in 1966. This makes sense. I mean, look at the current political climate — it has everyone questioning everything. American institutions themselves seem to be falling apart at the seams. But this new skepticism that has pervaded the country has public health professionals very worried.

Trust is the most integral part of any patient-physician relationship, so the lack of it can decrease a person’s likelihood to take a particular health action. Take, for example, vaccination. When patients refuse to immunize as a result of distrust, they endanger entire communities, and public health professionals could be tasked with containing an outbreak.The most glaring example is the recent measles outbreaks, which came as a result of vaccine non-compliance. Close to 90% of all people who are not immune to measles will contract the illness if they come in contact with an infected person. In these cases, containment is really difficult without some degree of institutional trust among target populations.

While this growing distrust is disconcerting, there is some good news: Trust can be rebuilt. One way is practicing cultural relativism. This means engaging with patients, keeping in mind that each person has a different socialization which can only be judged in the context of said person’s own culture. Another way is to include patients in decision-making and policy refinement. The goal of healthcare is to keep people healthy — we can’t do that unless the patients have a seat at the table. Finally, continuity of care is essential to building trust. Long-term patient-provider relationships can assist in promoting populations to take certain health-advised actions. A certain degree of cynicism is vital to healthy systems, but too much of it can be dangerous.