Friday, October 24, 2014

Satisfaction with Physicians High, Trust in Medical Profession Low

The October 23 issue of the New England Journal of Medicine contained an article “Public Trust in Physicians – U.S. Medicine in International Perspective” which contained contradictory findings among 29 ranked countries.

Country Rank,Satisfaction with Last Visit,Trust in Medical Profession
Switzerland 1, 1
Denmark 2, 2
United States 3. 24
Australia 4, 10
Norway 5. 12

In plain language, the United States ranked third in patient satisfaction, but 24th in trust of the medical profession. The former is cause for pride, the latter should cause deep concern.

Why does satisfaction with doctors during the last visit rank so high and trust in the medical profession rank so low?

The three authors , Robert Blendon, John Benson, and Joachim Hero, all from Harvard, offer the following speculation from a 29 country survey conducted from March 2011 to April 2013.

1) Some countries ranking above the U.S. 24th trust ranking had universal health systems, which the authors say “seems unlikely as a dominant factor."

2) Broad nonspecified cultural changes in the United States, resulting in only 23% of the public expressing a "great deal or quite a bit of confidence in the system" (Gallup).

3) 47% of Patients with low incomes are significantly less trusting, but ranked 7th in doctor satisfaction.

4) Medicare patients were significantly more likely than young Americans (69% to 55%) to trust doctors, and men were more likely than women to trust doctors (63% to 55%).

5) The U.S. political process, with extensive media coverage, makes physician advocacy “more contentious” than in other country.

6) The U.S. medical profession does not share in the management of the health system, as it does in other countries.

7) High health costs tend to make the public less trusting of doctors.

The authors vaguely conclude, without being specific, that trust in physicians could be improved “if the medical profession and its leaders deliberately take visible stands favoring policies that would improve the nation’s health and health care.” In my opinion, most professional associations have done so, but their stands have been lost in the media fog and controversy surrounding ObamaCare and its implementation.

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