Healthcare facing antagonism aimed at its credibility, authority
Organizations that long had reputations as the source of verifiable health information are increasingly being questioned and doubted.
Marcus Welby, MD. Ben Casey. Dr. Kildare. These TV physicians were the iconic popular representations of medical practice when clinical professionals’ knowledge, compassion and courage were unquestioned some 50 years ago.
The nation no longer resides in that black-and-white television world. Now, a population that believes it’s more informed and empowered to act is second guessing much of what the medical establishment is dishing out.
With the advent of greater access to healthcare information, consumers have Increasingly doubted the previously unquestioned belief that physicians and medical professionals were the source of all truth.
In sum, the industry is in the midst of a crisis of credibility and authority. Without that most basic level of trust, the industry faces new challenges in treating patients.
More information yields uncertainty
In recent years, quick access to material on the Internet has accelerated distrust of traditional medical knowledge and research.
The COVID-19 pandemic served as an accelerant for those who questioned medical guidance, as disinformation about potential treatments spread widely, and there was wide pushback against public health measures such as vaccines, wearing masks and social distancing.
Now, with the new administration naming health officials who have widely questioned traditional health practices, the industry faces new challenges in regaining credibility and public trust.
Why the distrust?
Access to information on the Internet has been a boon to consumer education and empowerment. However, search engines do a poor job of discriminating verifiable from unconfirmed information. And it’s become easier for entities to advertise on search engine websites, pushing their entries to the top of a consumer’s search query, making them more visible. Consumers are increasingly challenged to sort out commercially biased information from that offered by neutral, non-commercial sources.
The National Institutes of Health estimates that about 4.5 percent of all searches on the web might be health related. Google reports 150 million searches per day on all regional partner sites combined, which means that about 6.75 million health-related searches per day in Google alone are being conducted.
During the pandemic, consumers who were desperate for easy solutions were easy prey for unproven solutions such as ivermectin, the antimalarial drug chloroquine, as well as other sham products and regimens. Such alternative solutions received a prominent boost for a sizable segment of the U.S. population when then-President Trump suggested that bleach or light could be introduced into a person’s body to fight COVID-19 infections.
Concurrently, public health officials who pushed strategies such as social distancing, restrictions on public gatherings and other approaches were vilified by segments of the population that didn’t believe in the science underlying these approaches. To many, Anthony Fauci, MD, one of the lead members of the White House Coronavirus Task Force, became the focal point of anger against the pandemic response and the medical community.
But public perceptions of the health industry have been souring for years, research has shown. Health insurance companies have drawn much fire for coverage decisions, especially in widely publicized instances in which they’ve rescinded coverage after people were diagnosed with expensive illnesses like cancer. The use of prior authorization procedures that slow patients’ access to care has caused more consternation.
Providers are getting pushback, with anger being expressed against large bills and aggressive collection tactics. That, and infamous cases of medical errors, are reducing public trust in providers. And there’s been longstanding outrage at pharmaceutical companies’ high drug prices, exacerbated by a convoluted system of reimbursement that widely impacts out-of-pocket expenses for consumers.
Administration risks abound
With the new Trump administration taking form, there’s growing concern that accepted science will be called into question by those being nominated for healthcare-related positions.
Prime among those choices is Robert F. Kennedy Jr., nominated by Trump to be secretary of the Department of Health and Human Services. Kennedy has a long record of questioning the efficacy and safety of vaccines and other facets of long-accepted medical research. He’s called for further research into vaccines used to prevent diseases such as polio, measles and others.
Also nominated for key health and administrative roles are TV personality and former political candidate Mehmet Oz, MD, as head of the Centers of Medicare & Medicaid Services; Jay Bhattacharya, MD, to lead the National Institutes of Health; Marty Makary, MD, to head the Food and Drug Administration; and Janette Nesheiwat, MD, for U.S. surgeon general.
All have voiced controversial statements in public statements or on interviews on conservative broadcast networks. For example, Oz was once quoted as saying that the uninsured “don’t have a right to health,” only the “right to access a chance to get that health.” Bhattacharya was an opponent of pandemic lockdowns and vaccine mandates.
Lawrence Gostin, distinguished university professor at Georgetown University recently was quoted in Time Magazine as saying that “to say that RFK Jr. is unqualified is a considerable understatement. The minimum qualification for being the head of the Department of Health and Human Services is fidelity to science and scientific evidence, and he spent his entire career fomenting distrust in public health and undermining science at every step of the way.”
Furthermore, Peter Hotez, MD, dean for the National School of Tropical Medicine at the Baylor College of Medicine, termed the vaccine ecosystem as “fragile. It doesn’t take much for these diseases to come back, and you’ve got to maintain constant vigilance. We’re not being out there enough countering the anti-vaccine rhetoric.”
Hotez, who also serves as co-director of the Center for Vaccine Development at Texas Children’s Hospital, wrote the 2023 book, The Deadly Rise of Anti-Science, which discusses how the anti-vaccine movement became a dangerous political campaign promoted by elected officials and amplified by news media.
Regaining public trust
Federal officials like Kennedy and others nominated for the Trump administration are likely to further distrust in traditional medical practice and discount long-term findings of medical research.
Additionally, an entire ecosystem has been developed to cater to science deniers, hawking marginal products and distributing untested, fringe medical information.
Regaining consumer trust will be especially challenging in an environment where many outside of the profession are angry about costs and the time-consuming, convoluted paths they feel they must navigate to get care.
Additionally, efforts to roll back Social Security payments or Medicare coverage, and potentially to undo the Affordable Care Act, could risk eliminating medical coverage for millions of people, undermining their ability to pay for care. That will add more financial pressure, particularly to those facilities that are sole community providers, or serve underserved populations or rural communities.
Reversing these negative perceptions and countering misinformation will be an overarching challenge for those in the medical community for the next four years and beyond.