The President’s Podium: Opinions of our Profession

By Richard Pieters, M.D., President, Massachusetts Medical Society

My President’s Message in the November issue of Vital Signs, our monthly publication for MMS members, cited encouraging findings from The Physicians Foundation 2014 survey. The survey, which received  responses from more than 20,000 physicians across the U.S., found that 49 percent of us feel positive about the future of the medical profession. While that’s still below half, it’s a huge 26 percent increase from TPF’s 2012 survey.

Despite the trend, however, pessimism and negativity are growing, even from some colleagues within the profession. In an August 29 essay in The Wall Street Journal headlined Why Doctors Are Sick of their Profession, cardiologist Dr. Sandeep Jauhar writes:

“Today medicine is just another profession, and doctors have become like everybody else: insecure, discontented and anxious about the future …. The growing discontent has serious consequences for patients.”

Other physicians have expressed similar dissatisfaction with the profession, whether it stems from administrative overload, more legislative or regulatory requirements, or intrusion into the physician-patient relationship.

This kind of perspective is reaching patients. An essay entitled Doctors Tell All – and It’s Bad in the November edition of The Atlantic by Meghan O’Rourke – a self-described “patient and the daughter of a patient” – states:

“A recent crop of books offers a fascinating and disturbing ethnography of the opaque land of medicine, told by participant-observers wearing lab coats. What’s going on is more dysfunctional than I imagined in my worst moments…. Few of us have a clear idea of how truly disillusioned many doctors are with a system that has shifted profoundly over the past four decades.”

Medicine has indeed changed dramatically. But is our profession deteriorating as fast as some suggest? Are patients being negatively affected?

Many of us may bristle at the increasing administrative hassles, the interference in the physician-patient relationship, and the loss of independence.

I do not, however, believe medicine is “just another profession.” And I don’t think our patients do either.

Consider these assessments: a Gallup poll ranks doctors fourth among professions in honesty and ethics, and a Harris poll shows doctors to be regarded as the most prestigious occupation in America. The Harris poll also found that 91 percent of respondents would encourage a child to become a doctor.

Consider also an October 23 Perspective article in the New England Journal of Medicine, which seems to paint a different picture.

A review of polls on public trust in U.S. physicians and medical leaders from 1966 through 2014, as well as a survey of 29 countries, reveals that “public trust in the leaders of the U.S. medical profession has declined sharply over the past half century and that “the level of public trust in physicians as a group in the United States ranks near the bottom of trust levels in a survey of 29 industrialized countries.”

The authors of the article cite a Gallup poll of June 2014 indicating that only 23 percent of the public has confidence in the U.S. health care system. “We believe,” the authors write, “that the medical profession and its leaders are seen as a contributing factor.” Yet another Gallup poll released in November shows that 66 percent of Americans are satisfied with how the health care system works.

But here’s the key finding from the NEJM article: the decline in trust is not reflected in patient satisfaction with medical care. While the U.S. may rank near the bottom internationally in the public trust in physicians, it ranks near the top in patient satisfaction with medical treatment.

Our own public opinion poll of last year found a similar result. The overwhelming majority of Massachusetts residents (84 percent) remains as satisfied with the health care they receive as they were before reform began in 2006. The biggest reason: the “quality of care.” That reflects the work we’re doing as physicians.

So as the polls continue, and the pessimism persists, let’s take both in stride. Most of all, let’s listen, to our patients. They are, in the end, the best judges of our performance as physicians, and they’re telling us we’re doing well.

The President’s Podium appears periodically on the MMS Blog, offering Dr. Pieters’ commentary on a range of issues in health and medicine.

Comments are closed.