Doctor-patient relationship is fraying

Just as the political health of a nation requires trust in elected officials, the physical and mental health of Americans depends on the trust embedded in the doctor-patient relationship. For most of the past century, that bond was ironclad. Now, that relationship is fraying.

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Gallup polling shows just 44% of Americans rate the quality of care they receive as “good” or “excellent,” the weakest showing since Gallup began asking the question in 2001. Meanwhile, trust in doctors’ honesty and ethics has dropped 14 points since 2021, falling to its lowest point this century, according to the Tribune News Service.

At first glance, you might assume this decline resulted from recent, external factors: COVID-19, political polarization, and rising vaccine skepticism. Instead, today’s drop in confidence can best be understood as the predictable result of decisions physicians failed to make 20 years ago.

To understand why patients now rate their doctors so poorly, we need to trace the entire arc of modern medicine: how trust was built, how it reached its peak, and why it declined.