Doctors can help build trust in healthcare

Has the problem of mistrust in healthcare increased over the past few years? Yes, and COVID-19 made it worse, admits Dr Karan Thakur, Vice President, Public Affairs, Apollo Hospitals, India, in a candid chat with HealthLEADS.

The prevailing sense of mistrust between doctors and patients dates back to the pre-pandemic era. Long before COVID-19 upended our lives, there were already perceptible tensions and conflicts in the doctor-patient relationship. 

“There has been a general sense that medicine has become too commercialised. That it is driven by motives other than the benefit of the patient. And I think that has generated mistrust between patients and doctors. That’s regrettable,” says Dr Karan Thakur, Vice President, Public Affairs, Apollo Hospitals, India.

Here are the edited excerpts from the interview: 

Do people trust hospitals today?

In healthcare, the bedrock relationship is of trust. If you don’t trust your doctor or your healthcare provider, and/ the doctor does not trust their patients to follow through on treatments, it will not have the outcomes that one wishes for.

So, has the problem of mistrust increased over the past few years? I would say yes. Has COVID made that worse? Yes, it has. But, if you look at what happened during COVID, doctors were also struggling. The healthcare fraternity itself was struggling to find the right answers, to find the right treatments.

There were treatments which were bandied about. Many worked. Many did not work. But in the minds of people, who were really struggling at that time and looking towards doctors for a solution, it sometimes felt like the doctors were trying to push things that they knew did not work or know will not work. One has to realise that the medical fraternity was itself caught up in the storm and had never seen anything like this before.

However, during the pandemic a lot of people also saw healthcare workers very differently. They saw them as heroes. And I’m sure that that did move the trust quotient up vis-à-vis healthcare workers. So, one would have to see now how the relationship works post-pandemic.

Burnout among doctors was at an all-time high during the pandemic. As a hospital, what measures did you take to address this? 

We saw many healthcare professionals, particularly young professionals, struggling to deal with the turmoil and trauma that probably the generation that fought wars would have seen. I know a lot of colleagues, doctors, nurses, healthcare workers, who quit the profession or moved closer home. And that is understandable. 

As an organisation, we saw these professionals for what they were and not what we expect out of them. They are human too! It is okay for them to miss a day at work; it is okay for them to express their feelings. Our mental health teams worked closely with our healthcare workers.

We were all in it together, standing with each other, supporting each other. I think it fostered a deeper bonding between frontline workers and administrators, who have traditionally had a tenuous relationship in healthcare. 

Is there a stigma around doctors seeking help for their mental health?

One of the greatest tragedies is that many healthcare workers struggle with mental health issues, yet very few actually seek professional help. And a lot of this has to do with normative behaviours in healthcare. You are expected to work long hours. You are expected to see people dying without being affected by it. 

Today, it’s good to see that expectations from healthcare workers are evolving. A lot more needs to be done though. We’ve just scratched the surface. Mental health of healthcare professionals is a much bigger issue that needs to be addressed. 

How can doctors become more vocal about health issues on social media? 

I think this goes back to your first question about trust. We have to let go of this paternalistic attitude that healthcare traditionally has had – wherein we tell the patient and the patient is expected to just sort of nod and move on.

And that can happen with doctors becoming more accessible. Obviously, physical accessibility is limited, but through social media, through a more open dialogue, through more interaction with civil society and social institutions, doctors can help build trust in healthcare. 

Today, there are encouraging signs. There are medical practitioners who are putting out good information on Twitter and Instagram. I am happy to see more doctors talking about issues that matter.

What is it about work that excites you? 

A certain bit of invincibility that healthcare folks had about themselves has gone out of the window. And looking ahead, there is this looming challenge of climate change and its vagaries on diseases. If COVID was any indication of what one virus can do, do we have the wherewithal to manage what climate change can do to global health? 

I think climate change is going to be the next big public health challenge. And we need to start preparing for it.