7 ms·

Political beliefs affect patients' trust in doctors, study finds

27 points by geox 2y ago

duxup 2y ago
I don't go to the doctor a often as I should. I went recently and I could sense my doctor gear up for a sales pitch on catching up on my vaccines (it wasn't behind as much as it was time for a new TDAP. I stopped them and told them they didn't have to sell me on them I was cool with it. It's sad doctors have to spend their time on things that are clear benefits to people (and the people around them) like that.
- palmotea 2y ago
  > It's sad doctors have to spend their time on things that are clear benefits to people (and the people around them) like that. 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.
  - Scoundreller 2y ago
    “The big book of British smiles” https://www.youtube.com/watch?v=dF5mH_ggZv0 https://www.youtube.com/watch?v=dF5mH_ggZv0
  - deleted 2y ago
    [deleted]
  - dfxm12 2y ago
    Who are "they"? Doctors? Do you have quotes to back this up? 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.
    - palmotea 2y ago
      > Who are "they"? "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.
- trollbridge 2y ago
  I was living overseas (Australia) and went into the GP to request the 10 year booster for TDAP as I have been accustomed to thinking is necessary. 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/0031/989113/qld-immunisation-schedule-adolescent-adult.pdf 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-have-them/ 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/index.html 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.
  - duxup 2y ago
    We've had whooping cough in the US make the rounds in some areas so that might play into it. Having said that some googling indicates Australia does seem to generally recommend it: https://immunisationhandbook.health.gov.au/contents/vaccine-preventable-diseases/pertussis-whooping-cough https://immunisationhandbook.health.gov.au/contents/vaccine-...
    - trollbridge 2y ago
      Unless you’ve got some other risk factor, it’s only recommended for adults once they hit age 65. 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.
  - dboreham 2y ago
    See also wisdom teeth extraction.
    - trollbridge 2y ago
KittenInABox 2y ago
I noticed reading this and there is yet to be a study on if this affects patient outcomes, which is where the real meat is, IMO. 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.
- dfxm12 2y ago
  Do you have evidence of any doctors preventing people from detransitioning or something, before you "both sides" this issue further?
potato3732842 2y ago
It should be unsurprising that people don't want to entrust their health to people who don't share the same values as them regardless of what those values are. 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.
- duxup 2y ago
  Presumably being healthy is a value / hope everyone has in common with their doctor.
  - latexr 2y ago
    Considering the number of doctors who refuse to assist women with miscarriages or any kind of abortion even when the women’s life is in danger, I wouldn’t trust that presumption. Doctors routinely refuse care for religious beliefs or recommend needless procedures and medications¹ for profit, you can’t trust they care for your health just because of their profession. ¹ Sometimes they’re even worse than needless and are actively harmful, such as the overprescription of antibiotics.
    - duxup 2y ago
      >Doctors routinely refuse care for religious beliefs or recommend needless procedures and medications¹ for profit 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".
      - latexr 2y ago
        > I've never experienced the first part 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/religious-refusal-and-reproductive-health 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.
lupusreal 2y ago
For me, it's past experiences with doctors. Trusted them, got a surgery that they said would be beneficial, they tortured me with inadequate anesthetics, had complications lasting years, and found out afterwards that the procedure was totally unnecessary and the ostensible harm it was meant to preempt was very unlikely and would have been a much less extreme procedure. Still have the scars. I look at American doctors living in big houses, hear other stories like mine, and connect the dots. They recommend procedures to make themselves money.
- mightyham 2y ago
  There are simply too many economic incentives encouraging doctors to not act in a patient's best interest that, as the parent comment points out, it would be irresponsible to not be skeptical of their advice.
meh999 2y ago
> That’s alarming because life expectancy has stagnated in the United States and declined in the early 2020s, O’Brian said. 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.
- Braxton1980 2y ago
  A doctor has a higher probability of being right. Not trusting doctors is trusting yourself, unless you're a doctor you're more likely to be wrong
  - meh999 2y ago
    I did not say 'don't trust', I said 'don't trust blindly without taking 2nd or 3rd opinion' trusting blindly is as bad, if not worse than not trusting at all- 'above all do no harm'
    - Braxton1980 2y ago
      What's the difference between trusting a doctor and trusting a doctor blindly? 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
      - meh999 2y ago
        Blindly, strong word- I agree. 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'
jeffbee 2y ago
How much of this in influenced by the base rate of partisanship among medical doctors? 50 years ago, both Republicans and Democrats were equally likely to hold a prestigious occupation, but now, along with the yawning educational gap, there is a huge gap in prestigious occupations favoring people with liberal political beliefs. If I hear about a doctor who advertises their service on "conservativeprofessionals dot com" I think I would be right to wonder if they were some kind of disbarred chiropractor hawking steroids and horse drugs.
- derbOac 2y ago
  I think there's been a number of studies showing that overall political identification among physicians and providers is pretty balanced in the US, but it varies a lot by specialty area, so that some areas tend to have providers that are fairly politically conservative, and other areas tend to have providers that are politically liberal (in the US sense).
  - jeffbee 2y ago
    Doctors as a population are "pretty balanced" I guess but they are an entire SD to the left of the general American population. 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.
marcodiego 2y ago
In Brazil, people who support bolsonaro are more likely to believe in conspiracy theories and not trust doctors, vaccine or science. 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-atender-bebe-que-tem-mae-petista/318038507 https://www.jusbrasil.com.br/noticias/medica-se-recusa-a-ate...
Apreche 2y ago
Interesting how the people with the most distrust for authority are also the most in favor of authoritarianism.
- soco 2y ago
  Maybe because the distrusted authority are "the others" while the authoritarians are "our people".
- rachofsunshine 2y ago
  I think this is the wrong framing. They're not trustful or distrustful of authority in some abstract sense. They don't think in those terms. They think in terms of discomfort and of fear. "Is what this person is asking me to do unpleasant for me?" or "is it scary to me, in that it involves something I don't understand or creates uncertainty I can't cognitive-dissonance my way out of?" 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. [1] https://news.ycombinator.com/item?id=43265532 https://news.ycombinator.com/item?id=43265532
alkonaut 2y ago
This is hardly surprising given the attack on knowledge by populists in recent years. If you aren't subscribing to the populist views of science, knowledge and experts, you aren't going to trust the people you need to trust (experts such as doctors, economists and scientists). Likewise if I entered a doctors' office and saw or heard signs they themselves subscribe to these beliefs (e.g. are anti vaccine like ) then it would be pretty natural to distrust this doctor. So the bottom line is that this works both ways, but one way is correct and the other isn't.
nzach 2y ago
Isn't 'doctors political beliefs' just another axis(proxy) people can use to make a guess about the competency level of said doctor? 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.
- duxup 2y ago
  It would fit the pattern of the current US administration / GOP where any given thought, opinion, lifestyle that isn't their own is bad...
  - Extropy_ 2y ago
    Is that not the same for the Democrats?
    - rfrey 2y ago
      As an outsider looking in, no. 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.
      - jl6 2y ago
        If it were that easy there would be no issue. 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?
    - duxup 2y ago
      I find democrats efforts misguided, but rarely are they "my views only, exclude all others". They don't typically involve library book challenges, what appear to be ctrl+f searches for specific terms that relate to people unlike them, don't involve "report on your coworkers" type demands, and so on. And most of all they don't seem to identify any and all differing views as "enemies" and so on.
Havoc 2y ago
Reminds me of how belief in vaccines seems to have a pretty strong political component too. At least lately.
Braxton1980 2y ago
[flagged]
- Extropy_ 2y ago
  Do you genuinely wish wanton death on vast swaths of the population for political purposes?
  - Braxton1980 2y ago
    No but if it happens through their own fault I wouldn't be upset
- _ea1k 2y ago
  Your "hope" is that ~5% of the population dies due to a virus?
  - Braxton1980 2y ago
    Of Republicans not any of the population
dboreham 2y ago
Isn't this basically about how stupid people are? Once you're stupid/ignorant/don't have critical thinking skills, all sorts of consequences follow.
seethedeaduu 2y ago
Most trans people that I know don't trust doctors and that's for a good reason. The average trans person tends to be more educated about our healthcare compared to the average doctor. Not to mention the gatekeeping and outright maliciousness.
- voidUpdate 2y ago
  I personally don't distrust doctors, I'm just depressed at the complete lack of support I've received from them. I've been on a waiting list to have a first appointment about being trans for like 2 years now, I gave up and started sourcing my own medication nearly a year ago now
pessimizer 2y ago
Liberals' trust in authority figures has soared since 2016. It's not just doctors, but also the FBI, CIA, and the Pentagon. Anything that seems critical of Trump, even in a symbolic way, is trusted. 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.
- creaturemachine 2y ago
  Pretty reliable sanity check, don't you think?
beardyw 2y ago
Darwin Awards https://en.wikipedia.org/wiki/Darwin_Awards https://en.wikipedia.org/wiki/Darwin_Awards
trelane 2y ago
The findings in TFA are much more politically neutral than the knee jerk HN "republicans bad" commenters seen to believe. Which is something many of you should pause and reflect on. braces for the downvotes
- Yizahi 2y ago
  One doesn't exclude the other. The levels of anti-science pushed by the right wingers are objectively insanely high, regardless of the resulting ideas of population subjected to said propaganda.
bArray 2y ago
[flagged]
hayst4ck 2y ago
There are two fundamental political systems and they exist in respect to how they attempt to assess truth. The first uses reason, the second uses power. 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.
ankushnarula 2y ago
Lemme tell you about a client who confronted his therapist in 2019 about how using non-clinical political personalities as reference points was eroding the feeling of trust - and also that pathologizing public entities without clinical access projects weak professional ethics. 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.”

27 points by geox 2y ago

I don't go to the doctor a often as I should. I went recently and I could sense my doctor gear up for a sales pitch on catching up on my vaccines (it wasn't behind as much as it was time for a new TDAP. I stopped them and told them they didn't have to sell me on them I was cool with it. It's sad doctors have to spend their time on things that are clear benefits to people (and the people around them) like that.

palmotea 2y ago
> It's sad doctors have to spend their time on things that are clear benefits to people (and the people around them) like that. 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.
- Scoundreller 2y ago
  “The big book of British smiles” https://www.youtube.com/watch?v=dF5mH_ggZv0 https://www.youtube.com/watch?v=dF5mH_ggZv0
- deleted 2y ago
  [deleted]
- dfxm12 2y ago
  Who are "they"? Doctors? Do you have quotes to back this up? 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.
  - palmotea 2y ago
    > Who are "they"? "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.
trollbridge 2y ago
I was living overseas (Australia) and went into the GP to request the 10 year booster for TDAP as I have been accustomed to thinking is necessary. 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/0031/989113/qld-immunisation-schedule-adolescent-adult.pdf 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-have-them/ 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/index.html 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.
- duxup 2y ago
  We've had whooping cough in the US make the rounds in some areas so that might play into it. Having said that some googling indicates Australia does seem to generally recommend it: https://immunisationhandbook.health.gov.au/contents/vaccine-preventable-diseases/pertussis-whooping-cough https://immunisationhandbook.health.gov.au/contents/vaccine-...
  - trollbridge 2y ago
    Unless you’ve got some other risk factor, it’s only recommended for adults once they hit age 65. 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.
- dboreham 2y ago
  See also wisdom teeth extraction.
  - trollbridge 2y ago

KittenInABox 2y ago

I noticed reading this and there is yet to be a study on if this affects patient outcomes, which is where the real meat is, IMO. 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.

dfxm12 2y ago
Do you have evidence of any doctors preventing people from detransitioning or something, before you "both sides" this issue further?

potato3732842 2y ago

It should be unsurprising that people don't want to entrust their health to people who don't share the same values as them regardless of what those values are. 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.

duxup 2y ago
Presumably being healthy is a value / hope everyone has in common with their doctor.
- latexr 2y ago
  Considering the number of doctors who refuse to assist women with miscarriages or any kind of abortion even when the women’s life is in danger, I wouldn’t trust that presumption. Doctors routinely refuse care for religious beliefs or recommend needless procedures and medications¹ for profit, you can’t trust they care for your health just because of their profession. ¹ Sometimes they’re even worse than needless and are actively harmful, such as the overprescription of antibiotics.
  - duxup 2y ago
    >Doctors routinely refuse care for religious beliefs or recommend needless procedures and medications¹ for profit 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".
    - latexr 2y ago
      > I've never experienced the first part 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/religious-refusal-and-reproductive-health 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.

lupusreal 2y ago

For me, it's past experiences with doctors. Trusted them, got a surgery that they said would be beneficial, they tortured me with inadequate anesthetics, had complications lasting years, and found out afterwards that the procedure was totally unnecessary and the ostensible harm it was meant to preempt was very unlikely and would have been a much less extreme procedure. Still have the scars. I look at American doctors living in big houses, hear other stories like mine, and connect the dots. They recommend procedures to make themselves money.

mightyham 2y ago
There are simply too many economic incentives encouraging doctors to not act in a patient's best interest that, as the parent comment points out, it would be irresponsible to not be skeptical of their advice.

meh999 2y ago

> That’s alarming because life expectancy has stagnated in the United States and declined in the early 2020s, O’Brian said. 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.

Braxton1980 2y ago
A doctor has a higher probability of being right. Not trusting doctors is trusting yourself, unless you're a doctor you're more likely to be wrong
- meh999 2y ago
  I did not say 'don't trust', I said 'don't trust blindly without taking 2nd or 3rd opinion' trusting blindly is as bad, if not worse than not trusting at all- 'above all do no harm'
  - Braxton1980 2y ago
    What's the difference between trusting a doctor and trusting a doctor blindly? 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
    - meh999 2y ago
      Blindly, strong word- I agree. 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'

jeffbee 2y ago

How much of this in influenced by the base rate of partisanship among medical doctors? 50 years ago, both Republicans and Democrats were equally likely to hold a prestigious occupation, but now, along with the yawning educational gap, there is a huge gap in prestigious occupations favoring people with liberal political beliefs. If I hear about a doctor who advertises their service on "conservativeprofessionals dot com" I think I would be right to wonder if they were some kind of disbarred chiropractor hawking steroids and horse drugs.

derbOac 2y ago
I think there's been a number of studies showing that overall political identification among physicians and providers is pretty balanced in the US, but it varies a lot by specialty area, so that some areas tend to have providers that are fairly politically conservative, and other areas tend to have providers that are politically liberal (in the US sense).
- jeffbee 2y ago
  Doctors as a population are "pretty balanced" I guess but they are an entire SD to the left of the general American population. 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.

marcodiego 2y ago

In Brazil, people who support bolsonaro are more likely to believe in conspiracy theories and not trust doctors, vaccine or science. 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-atender-bebe-que-tem-mae-petista/318038507 https://www.jusbrasil.com.br/noticias/medica-se-recusa-a-ate...

Apreche 2y ago

Interesting how the people with the most distrust for authority are also the most in favor of authoritarianism.

soco 2y ago
Maybe because the distrusted authority are "the others" while the authoritarians are "our people".
rachofsunshine 2y ago
I think this is the wrong framing. They're not trustful or distrustful of authority in some abstract sense. They don't think in those terms. They think in terms of discomfort and of fear. "Is what this person is asking me to do unpleasant for me?" or "is it scary to me, in that it involves something I don't understand or creates uncertainty I can't cognitive-dissonance my way out of?" 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. [1] https://news.ycombinator.com/item?id=43265532 https://news.ycombinator.com/item?id=43265532

alkonaut 2y ago

This is hardly surprising given the attack on knowledge by populists in recent years. If you aren't subscribing to the populist views of science, knowledge and experts, you aren't going to trust the people you need to trust (experts such as doctors, economists and scientists). Likewise if I entered a doctors' office and saw or heard signs they themselves subscribe to these beliefs (e.g. are anti vaccine like ) then it would be pretty natural to distrust this doctor. So the bottom line is that this works both ways, but one way is correct and the other isn't.

nzach 2y ago

Isn't 'doctors political beliefs' just another axis(proxy) people can use to make a guess about the competency level of said doctor? 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.

duxup 2y ago
It would fit the pattern of the current US administration / GOP where any given thought, opinion, lifestyle that isn't their own is bad...
- Extropy_ 2y ago
  Is that not the same for the Democrats?
  - rfrey 2y ago
    As an outsider looking in, no. 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.
    - jl6 2y ago
      If it were that easy there would be no issue. 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?
  - duxup 2y ago
    I find democrats efforts misguided, but rarely are they "my views only, exclude all others". They don't typically involve library book challenges, what appear to be ctrl+f searches for specific terms that relate to people unlike them, don't involve "report on your coworkers" type demands, and so on. And most of all they don't seem to identify any and all differing views as "enemies" and so on.

Havoc 2y ago

Reminds me of how belief in vaccines seems to have a pretty strong political component too. At least lately.

Braxton1980 2y ago

[flagged]

Extropy_ 2y ago
Do you genuinely wish wanton death on vast swaths of the population for political purposes?
- Braxton1980 2y ago
  No but if it happens through their own fault I wouldn't be upset
_ea1k 2y ago
Your "hope" is that ~5% of the population dies due to a virus?
- Braxton1980 2y ago
  Of Republicans not any of the population

dboreham 2y ago

Isn't this basically about how stupid people are? Once you're stupid/ignorant/don't have critical thinking skills, all sorts of consequences follow.

seethedeaduu 2y ago

Most trans people that I know don't trust doctors and that's for a good reason. The average trans person tends to be more educated about our healthcare compared to the average doctor. Not to mention the gatekeeping and outright maliciousness.

voidUpdate 2y ago
I personally don't distrust doctors, I'm just depressed at the complete lack of support I've received from them. I've been on a waiting list to have a first appointment about being trans for like 2 years now, I gave up and started sourcing my own medication nearly a year ago now

pessimizer 2y ago

Liberals' trust in authority figures has soared since 2016. It's not just doctors, but also the FBI, CIA, and the Pentagon. Anything that seems critical of Trump, even in a symbolic way, is trusted. 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.

creaturemachine 2y ago
Pretty reliable sanity check, don't you think?

beardyw 2y ago

Darwin Awards https://en.wikipedia.org/wiki/Darwin_Awards https://en.wikipedia.org/wiki/Darwin_Awards

trelane 2y ago

The findings in TFA are much more politically neutral than the knee jerk HN "republicans bad" commenters seen to believe. Which is something many of you should pause and reflect on. braces for the downvotes

Yizahi 2y ago
One doesn't exclude the other. The levels of anti-science pushed by the right wingers are objectively insanely high, regardless of the resulting ideas of population subjected to said propaganda.

bArray 2y ago

[flagged]

hayst4ck 2y ago

There are two fundamental political systems and they exist in respect to how they attempt to assess truth. The first uses reason, the second uses power. 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.

ankushnarula 2y ago

Lemme tell you about a client who confronted his therapist in 2019 about how using non-clinical political personalities as reference points was eroding the feeling of trust - and also that pathologizing public entities without clinical access projects weak professional ethics. 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.”