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September 23, 2022, 10:45 a.m. David Mitchell (Washington, D.C.) — As a family physician, how do you win back public trust? How do you stop the wave of medical misinformation that flows from social media, the internet and word of mouth?
“If there’s a problem with (trust in) health care, there’s no solution without you,” said best-selling author and New Yorker staff writer Malcolm Gladwell, addressing an audience of family physicians on Sept. 21 during the Family Medicine Experience.
“You can’t solve it with better technology. You can’t solve it with better drugs. You can’t solve it with a fancy EMR. We solve it with communication, listening and empathy,” Gladwell said. “We’ve asked people to accept a lot of new information … people need time.”
Gladwell offered examples of several organizations and institutions that suffered from a lack of public trust, or damaged trust, before ultimately changing public perception for the better.
When the ergonomic Aeron Chair made its debut in the 1990s, facility managers weren’t impressed. Its mesh design was deemed “ugly,” and it scored poorly in focus groups.
“Office chairs used to be thick, padded and hot,” Gladwell said. “When we encounter something new, the feeling of, ‘I hate this,’ feels a lot like the feeling of ‘I don’t understand this.’”
“Ugly,” it turns out, was just a proxy for “different.” Consumers needed time to adjust to an innovative product, and now millions of Aeron Chairs are sold each year.
“It takes time,” Gladwell said.
And that’s true in medicine, too.
In 1917, a study in Akron, Ohio, found that iodine supplementation reduced the incidence of goiter. Public health recommendations to add iodine to salt led to public outcries about infringed liberties.
“Sound familiar?” Gladwell asked, tongue firmly in cheek.
By 1927 another study had confirmed the earlier findings regarding iodine supplementation, but a survey found that more than 70% of public health officials still opposed it.
“They were saying, ‘I don’t know, man,’” Gladwell said. “’I’d rather take my chances with goiter.’”
Nearly a century later, physicians are faced with patients and parents who are skeptical of and resistant to vaccines.
“We forget that we have asked the American public to accept a lot,” said Gladwell, noting a novel disease, lockdowns, remote work and school, masking and more. “Then we add a vaccine based on new technology that ‘I can’t explain to you but want you to take right away.’”
A January 2021 survey showed that nearly 40% of Americans were enthusiastic for COVID-19 immunizations, while 17% were “genuinely hostile” about the new vaccines. The remaining 43% were somewhere in between.
“They need time to think about it,” Gladwell said. “They need someone to take them by the hand and be empathetic, all the things that allow someone on the fence to step in an unfamiliar direction.”
Family physicians, Gladwell declared, are in the right position to lead the way.
“You’ve invested to deliver a high level of care to patients,” he said. “You chose to be family doctors. You are people who have real conversations with patients. We can’t solve this trust issue without you. Now your challenge is to make the case to others: ‘You can’t do this without us!’”