Trust in Physicians and Hospitals During the COVID-19 Pandemic in a 50-State Survey of US Adults, 2024, Uslu et al

Trust in Physicians and Hospitals During the COVID-19 Pandemic in a 50-State Survey of US Adults
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2821693

Importance Trust in physicians and hospitals has been associated with achieving public health goals, but the increasing politicization of public health policies during the COVID-19 pandemic may have adversely affected such trust.

Main Outcome and Measure Self-report of trust in physicians and hospitals; self-report of SARS-CoV-2 and influenza vaccination and booster status. Survey-weighted regression models were applied to examine associations between sociodemographic features and trust and between trust and health behaviors.

Results The combined data included 582 634 responses across 24 survey waves, reflecting 443 455 unique respondents. The unweighted mean (SD) age was 43.3 (16.6) years; 288 186 respondents (65.0%) reported female gender; 21 957 (5.0%) identified as Asian American, 49 428 (11.1%) as Black, 38 423 (8.7%) as Hispanic, 3138 (0.7%) as Native American, 5598 (1.3%) as Pacific Islander, 315 278 (71.1%) as White, and 9633 (2.2%) as other race and ethnicity (those who selected “Other” from a checklist). Overall, the proportion of adults reporting a lot of trust for physicians and hospitals decreased from 71.5% (95% CI, 70.7%-72.2%) in April 2020 to 40.1% (95% CI, 39.4%-40.7%) in January 2024. In regression models, features associated with lower trust as of spring and summer 2023 included being 25 to 64 years of age, female gender, lower educational level, lower income, Black race, and living in a rural setting. These associations persisted even after controlling for partisanship. In turn, greater trust was associated with greater likelihood of vaccination for SARS-CoV-2 (adjusted odds ratio [OR], 4.94; 95 CI, 4.21-5.80) or influenza (adjusted OR, 5.09; 95 CI, 3.93-6.59) and receiving a SARS-CoV-2 booster (adjusted OR, 3.62; 95 CI, 2.99-4.38).

Conclusions and Relevance This survey study of US adults suggests that trust in physicians and hospitals decreased during the COVID-19 pandemic. As lower levels of trust were associated with lesser likelihood of pursuing vaccination, restoring trust may represent a public health imperative.

 

Hard to imagine this will rise any time soon. There was an initial blip of goodwill and it all came crashing down, and will likely crash further when people start seeing the consequences of "Don't look up" and mass reinfections.

Especially not when there's an obvious lack of self-reflection about the reasons, seeing this mainly as PR issue that can be addressed with some "interventions".

The reasons they identified (N=200, the most dissatisfied):

Which need a lot of fleshing out. Much too superficial to get at the root cause of the issue.

Frankly I'm surprised it's this high.

Whenever I see high profile (lots of activity) threads on Reddit that have zero overlap with the chronic illness community, that is, outside of our bubble, it's still shocking how often I see this, how many people have shockingly bad experiences, with zero possibility of redress. This problem is very widespread and has zero means of even basic reporting. Health care rarely takes feedback from patients. They don't know any of this, they're completely blind to this problem. The traditional aristocratic top-down model is as bad for health as its political counterpart in governance.

Then you see medical forums and the discussions they have, and it's easy to see how deep this problem goes. But they can't see any of this, adopt an "us vs them" mentality that is at the core of most issues here, responding to the problems caused by the attitudes with the same attitudes that cause them. This is very bad and will no doubt spill over to experts in general.

In most industries this would be catastrophic. But health is completely inelastic, meaning that people have no choice but to go with the monopolistic tightly-regulated system. The only alternative is alternative medicine, wellness woo woo, and it's almost as big as health care in terms of dollars. Says a lot. It'd be as if people chose to eat rocks and mud cakes when there is free food available. That's how bad the experience is.