Political beliefs affect patients' trust in doctors, study finds
news.uoregon.edu
news.uoregon.edu
I wonder if that is due to listening to our doctors and not taking 2nd or 3rd opinion. I was asking many doctors to diagnoze my illness, and although all of them said my body is ill, they were giving different, sometimes even contradicting directions. My health is more valuable than trust to doctor, or to the system- everyone can make mistake and trusting blindly is not good for our health. Same effect as rejecting all opinions.
"Rejecting everything you're told is just as intellectually lazy as believing everything you're told."
Something I think about a lot.
There's a lot of default cynicism I see out on the internet and while it might be true that your doctor makes more money of they order that test ... it doesn't mean you shouldn't get that test.
trusting blindly is as bad, if not worse than not trusting at all- 'above all do no harm'
Maybe an example would help me understand because I'm concerned the word "blindly" is being used as a way to make the concept of trusting a doctor seem inherently wrong
By saying 'trusting blindly' I meant 'dismissing possibility of incorrect diagnosis and applying prescribed procedure withought weighting the risk'.
So, if GP gave diagnosis and informed about the risks and outlined other diagnosis that are less probable based on his experience, and the patient weighted the risk and decided to go with the procedure without taking 2nd opinion, that in my opinion would not be 'trusting blindly'
If they disagree then what?
Blinding trusting what a doctor says to do can absolutely lead to the wrong treatment and outcome.
At the very least you should get multiple opinions.
And then blindly trust those?
Blindly trusting means you are trusting something without verifying yourself (as in "seeing it for yourself, not being blind")
This doesn't apply if you can't do that yourself
But it probably won't be. Why would you counter an argument about probability by stating one outcome?
There's already a litany of incentives inherent to the modern medical workplace that ever so slightly tug doctors toward goals other than what is best for the customer, people aren't idiots, they're not going to add yet another one if they can help it. Nobody wants to have to worry about a values disagreement with their doctor on top of all the other stuff.
¹ Sometimes they’re even worse than needless and are actively harmful, such as the overprescription of antibiotics.
To note, recently, doctors are refusing this care due to their concern over legal liability in states with harmful policy prioritizing flawed belief systems over healthcare.
https://www.propublica.org/series/life-of-the-mother
> When the Supreme Court overturned Roe v. Wade in 2022, doctors warned that women would die, but lawmakers who passed state abortion bans didn’t listen. The worst consequences are now becoming clear.
https://news.ycombinator.com/item?id=42111924 (citations from a comment I wrote previously in a dead thread, linked for brevity vs wall of text)
Really bugs me that the people who championed the apparatus that enables the existence and implementation of such policy never consider their role.
It's like ascribing your 9th inning loss to a mediocre batter who got lucky when your own pitcher was dumb enough to send one straight down the middle.
I've never experienced the first part and the latter seems far less likely if you're doing a regular checkup / going in for a vaccine.
Either way the benefits of vaccines are obvious, proven, and I suspect the decision to not do it is something other than day of "I don't like my doctor".
Yet I’m sure you understand “it has never happened to me” isn’t synonymous with “it never happens”.
https://www.plannedparenthoodaction.org/issues/birth-control...
> and the latter seems far less likely if you're doing a regular checkup / going in for a vaccine.
Which most people don’t. Regardless, I’ve had doctors I know personally describe to me how certain colleagues are bad physicians who nevertheless make a ton of money for the hospital/clinic because they order a ton of unnecessary procedures. Yes, even when going for routine checks.
> Either way the benefits of vaccines are obvious
Which is true, but also has nothing to do with the conversation. No one in this thread has mentioned vaccines before you did just now. The article doesn’t mention it either. I’m not an anti vaxxer, nor have I assumed you were.
No, but it's a relevant data point that allows you to counterbalance possible sampling bias.
If everyone tells you people are poisoning halloween candy all the time, but no one within your direct experience encounters it, you should investigate possible sampling bias. Perhaps you are in a privileged context that avoids poison halloween candy, so the sampling bias is in your local environment. Or perhaps such stories easily go viral, so the sampling bias is in people's tendency to share sensational stories. Either way, you have something to watch for.
Relying on multiple weakly-correlated information channels is a good way to hedge yourself against dysfunction in any one of those channels.
I'm thinking the ones they describe are a lost cause and should be removed from the profession.
This isn't to say medicine is perfect, but you really should be questioning the motives of those calling it all a sham. Due to regulation, medicine is generally pretty well backed up.
It's surprising and stupid.
>There's already a litany of incentives inherent to the modern medical workplace that ever so slightly tug doctors toward goals other than what is best for the customer,
Like what?
Like drug companies spending millions wining and dining doctors for them to recommend their products.
I'm sure financially using brand drugs over a genetic, for example, could be more costly for the patient but that may not be danger medicially
I think it probably is irrational, but I don't think there's any way to combat such biases. It's just how humans as social species are - we're less likely to trust someone who doesn't trust our views or opinions.
During COVID doctors had their licenses to practice revoked if they weren't on board with public health policies (set by people who were not doctors).
In just one example of many, this doctor [1] had his license revoked and the tribunal specifically stated that he was expected to (ab)use his patient's trust to get them to comply with government policies, even though he disagreed with them on health grounds.
Some people either didn't realize this, or agreed with the policy of forcing doctor's hands, and so have continued to trust. But I'd argue that if you knew about this policy, it was 100% irrational to trust what doctors told you on anything COVID related. The whole basis of trust is the assumption the doctor is doing what's best for you as an individual, but a doctor cannot do that if the advice they think is correct for your individual case is illegal to give you.
[1] https://www.cbc.ca/news/canada/sudbury/patrick-phillips-trib...
Interference with testing of an infant, who was not his patient, for COVID-19;
Online disclosure of college investigative materials;
Failure to cooperate with the college's investigation; and
Failure to comply with an interim order imposed by the college.
> "As a physician, the information you communicate is trusted by many."
People don't trust us but they trust you, so we're going to make you into our handpuppets.
> "Online disclosure of a private letter received from an associate medical officer of health;"
Don't tell anyone we're using you this way, otherwise they'd stop trusting you too.
> "We are dismayed by the deliberate steps you took to undermine the public health response to the COVID-19 pandemic. Your communications to colleagues, patients and your thousands of followers on social media regarding COVID-19 and public health response measures were careless, often offensive and at times, possibly harmful."
Offending the government is the primary thing listed here; they aren't even sure he caused harm! The other charges are similar: he disagreed with the government on COVID, he revealed publicly that the government was threatening him, he didn't cooperate with the people who were threatening him, he "deterred the public from complying" and so on. Then something about an infant i.e. someone too young for an invasive COVID test to have value (so he was probably right to interfere with it).
Where was that? Also why would a conspiracy forbid people to talk about something when conspiracies often use evidence that something is trying to be hidden to prove their point
> Also why would a conspiracy forbid people to talk about something
It's not a conspiracy if there's no attempt to keep it secret, is it?
The fact that some conspiracies are sometimes detected due to mistakes or whistleblowers doesn't mean their attempts at secrecy were useless. Presumably there are conspiracies that are never detected, but even if they are, secrecy and intimidation tactics still have value to the conspirators. Look at this very thread: it's full of people baffled that anyone might not trust their doctor. But if doctors are being forced to toe the line and not reveal that they're being so forced, then you aren't trusting a doctor, you're trusting someone in the licensing authority or public health agencies - very different.
If you can support Kristi Noem shooting her dog and disappearing people to foreign torture prisons, you can't be trusted to treat my loved ones.
Trump has recently used the word "love" to describe how Nazis treated Jewish prisoners. This is a party that has embraced attacking empathy as sinful. I'd trust a MAGA vet to get livestock to market profitably, maybe, but never with anything or anyone I love.
Doctors ask you to do things that are unpleasant, involve things you don't understand, and create uncertainty. Your doctor says "hey, your blood pressure is high, you need to eat less salt, but that may or may not solve your problem." If you believe them, you have to measurably damage your quality of life, you have to trust in a bunch of medicine that you don't fully understand, and you now have to worry about whether your health will ever improve (when there is a very real chance that it will not). Or you can go "actually doctors are all quacks and if I just eat Natural Whole Foods(TM) I'll be fine" and have an approach that asks you to do things that make you feel good, fits within an intuitive model of the world, and creates artificial certainty.
In isolation, this isn't new. What is new is that:
- The asks have been unusually unpleasant in recent memory. COVID lockdowns are a particular focal point for a reason: they were psychologically painful and involved a distant and low-probability threat in the minds of most people. (To be clear, I think they were clearly correct policy - but that didn't make them fun.)
- The world is a lot scarier and more uncertain than people are used to, so acknowledging the facts has a higher emotional cost.
- The truth is more muddled than it used to be for most people. They're bombarded with an enormous amount of misinformation. Even if you're good at filtering misinformation and avoid uptake of 90% of it, the 10% that gets through can erode trust. And institutions - while still on balance the best source of information available to a layperson - have been abusing that trust enough that some suspicion is warranted.
- Propaganda is channeled through social connections untraceable to organizations. You might not believe a youtube video if it tells you about chemtrails, but you might believe your friend, who heard it from a friend, who saw it in a youtube video. And algorithmic targeting means you can be served exactly the propaganda that strikes your biases and vulnerabilities.
------------
The authoritarianism you're talking about, on the other hand, says:
- You should not be asked to do anything new or process the discomfort of cognitive dissonance. In fact, the things you've already been asked to do were unfair and targeted oppression aimed at you.
- The world is scary, just like you feel it is, but in a narrow and controllable way. You have agency over your fear, and a champion who fights for you, and you won't (say) die of a random disease because of a bad roll of the dice.
- The truth is simple: I am telling you the truth, always, and our enemies are telling lies, always.
- You don't need to listen to authorities who are scary and untrustworthy. Just listen to your neighbor or your favorite TikTok creator, who you trust and feel safe around.
In that sense, it doesn't feel authoritarian, because it isn't authoritarian to them. It asks them nothing, and in some cases, less than nothing. It oppresses someone else, asks someone else to sacrifice, removes someone else whose presence may cause cultural discomfort or cognitive dissonance, and promises simple, certain, free solutions. This is why you see people affected by layoffs or tariffs or whatever going "wait, um, there must be some mistake, obviously this couldn't affect me" - that really is what they believe.
That's not to say that there are not very serious problems with the status quo. There are, and that's part of what's fueling these (malignant) solutions.
I made a comment about a month ago [1] that applies again here: the average person is usually good at identifying problems but terrible at identifying solutions. And when the average person has been able to identify problems for decades and institutions have failed to solve them, they're less likely to hold the line against misinformation and mob rule. That goes double when the average person's life has gotten significantly more uncomfortable and scary, reducing their appetite for self-sacrifice in a world that is extracting more and more of their well-being.
One of the experiments is described as: "In their first experiment, the researchers created two fictitious profiles of dermatologists and randomly varied different attributes, such as race, gender, school attended, online ratings and political affiliation. Asked which dermatologist they were more likely to visit, both Republican and Democratic respondents preferred a doctor who shared their political beliefs."
It makes sense to me that a conservative person who is anti-abortion, wary of early sexual education or birth control, concerned about their child being exposed to gender transition or whatever other politics would want to see a doctor who simply would never suggest those things. It also makes sense to me that a progressive trans/gay person or supportive parent of a transgender/gay child would seek out progressive doctors who wouldn't try to convince them to detransition/conversion therapy or something.
If you 1 - think X and also 2 - think that everyone who doesn't hold the same belief is "dumb"/evil. Isn't logical to think a doctor is less "capable" (whatever that means to you) if he/she doesn't hold the same beliefs that you do ?
My take is that the polarization/radicalization that is happening in the last 10 years made the second point pretty common (i.e. to think everyone who doesn't agree with you is dumb/evil) and this is just the consequence of this kind of thinking.
At this level, there's nothing good/evil about medical science. It's as amoral as the sun rising in the day and setting at night. It doesn't matter what you feel about immigrants, tariffs or the price of eggs. As long as the FDA is able to do its job, treatments are tested. We know the effects and side effects of treatments.
The democrats seem as likely to choke down on speech, but it tends to be speech that represses others. The republicans choke down on speech that contradicts their vision of society or their personal moral compass. Although both contradict free speech absolutism, they are IMO fundamentally different.
If I were possessed of a religious faith that considered my name to be so holy that it must not be spoken, would a law against saying my name repress others, or would lack of that law repress me?
And most of all they don't seem to identify any and all differing views as "enemies" and so on.
This is about patients' political beliefs.
But my main point was wouldn't a doctor advertising their services specifically to a conservative audience be a huge red flag? Has anyone ever heard of doctors hanging out their shingle on "wokedoctors dot com"? Note, this wasn't one of the hypotheticals offered in the study.
And six years later the same client said “I don’t care anymore, say whatever you like, and I will explain how you may be projecting your personal fears on me.”
People who believe in reason based truth look for contradictions. Do doctors take the same treatments they offer? Do doctors vaccinate their own kids? What did these doctors learn to do in college? When no or few contradictions are found, they are willing to offer trust.
People who believe in power based truth look to their power structure. What does my priest or parent say? What does my news channel say? What do people who are loyal to the same people I'm loyal to say? When the messaging within their power structure, such as fox news, declares something they believe it without question, after all, they wouldn't be in their position of power without having earned it. Likewise there are peer social relationships likely to punish dissent.
It's hard for people who believe in reason to communicate with people who believe in power because power is immune to reason. They don't care about their contradictions. While you are pointing out their contradictions, but not doing anything about it, you are dis-empowering yourself. There is truth in action, and in many ways reasoning is not action. Acting in a contradictory way, but experiencing no obvious consequences for doing so is itself empowering.
braces for the downvotes
It's sad doctors have to spend their time on things that are clear benefits to people (and the people around them) like that.
The doctor just laughed and said "You must have spent time in America." The only recommendation for TDAP for adults is during pregnancy. See https://www.health.qld.gov.au/__data/assets/pdf_file/0031/98...
Meanwhile, in the UK, the T and D of TDAP are given just once (part of Td/IPV), with the P given only to pregnant women. See https://www.nhs.uk/vaccinations/nhs-vaccinations-and-when-to...
Upon return to the U.S., my doctor strongly recommended getting the TDAP again since it had been well over 10 years, with 5 shots for kids and then again every 10 years. See https://www.cdc.gov/diphtheria/hcp/vaccine-recommendations/i...
I will admit that now I have no idea what the actual best schedule for these is.
U.S. just tells everyone to get a TDAP (not just pertussis) every 10 years.
Obviously, one is right and one is wrong, who knows which one.
Honestly, I don't think it is. It's probably a big, big component of vaccine hesitancy is that doctors/media/government (collectively) dropped the ball on explaining the "clear benefits to people," so the narrative got away from them.
They tried to course correct with arguments from authority ("We, the medical profession say this is good, so comply!") and ridicule/shame ("Vaccines are good, if you have doubts you are stupid or malicious"), but that just made people dig in. What they should have done is show, "This is what measles looks like, and this is what it could happen to your kid if they get it. This vaccine will prevent that."
For like 50 years, they were coasting on people's 1st hand experience with diseases like measles to drive vaccine acceptance, but when that experience is 3rd or 4th hand, they can't coast anymore.
"doctors/media/government (collectively)"
> Do you have quotes to back this up?
I was there, I don't have time to dig up quotes for you. But if quotes will satisfy you, they shouldn't be too hard to fine yourself.
> Because if we're considering the cause of vaccine hesitancy during COVID-19, every component was dwarfed by the full force of conservatives media, politicians and social media influencers lying about the vaccines.
My point is by that time the public health apparatus had already dropped the ball on vaccines.
Also, your precis reads as a convenient partisan narrative, with others taking all the blame. Nothing is really that simple. IMHO, it's far more helpful to think about how your side messed up, rather than dwelling on the other side.
I also think it is reasonable for everyone to have a tendency to not trust a doctor who is a bolsonaro supporter.
There is a very emblematic case, although not very known, of a doctor who refused to treat the child a a Lula supporter: https://www.jusbrasil.com.br/noticias/medica-se-recusa-a-ate...
I think incidences of injustices and abuse of trust from institutions actually strengthens movement liberal support of them. I think they see corrupt institutions as the most vulnerable to Trump attacks, and therefore the most in need of defense.