Excellent piece. ER doc for 30+ years and worked through all of Covid. Could not communicate with the patients due to pappers, mask, garb, no visitors, patients couldn’t hear w no hearing aids, they couldn’t read lips, it was painful. One day made the executive decision took it all off and never looked back. Wore blue jeans, no mask, did every single procedure in our profession including airways without the nonsense. I never had so much as a runny nose, never tested positive ever, never missed one day of work through Covid nor in my entire career. Meanwhile, I had younger partners that called in sick because their cousin tested positive. Fools follow other fools off a cliff.
Medicine since then has not been doing a good job with “gender affirming” medication and surgeries either. The AAFP and others adopted the language, and even now, the number one thing that shows up under a patient’s name is “gender identity” in Epic. This is a radical adoption of an ideology and practice without much, if any, evidence on its side.
The go-along to get-along is partly to blame. The true experts are silenced while the charlatans are given the podium. How many instances of “ nutraceuticals “ claiming benefits on cholesterol or ED have been proven to have statins or sildenafil respectively and how were these companies sanctioned ? Are the three-letter agencies still trying to protect the public? $$$$$ makes monkey dance ?
On masking, a patient put it in very simple terms : “ you mean to tell me y’all are trying to keep mosquitoes out with a three strand barbed wire fence ? “
excellent piece right on! The problem with science is even the research , NIH,FDA and journals have now been compromised so its hard to evaluate data and trust anything you see ---
These are great points, but I think the problem runs much deeper. COVID policy nonsense has led more and more people to question the reliability of healthcare as a whole. What can we really believe? A team of scientists, including John Ioannidis, analyzed over 1,600 Cochrane reviews and found that only 5.6% of medical services can be shown to be effective, based on high-quality evidence. They also found high-quality evidence that 8.1% are harmful, possibly as high as 36.8%. Cochrane reviews are considered the gold standard in evidence-based medicine. The healthcare system is eroding the standard of living for the working class, taking almost 20% of our national income. And what do we get?
I think he’s missing the larger point. The greatest reason people don’t trust medicine is because medicine is nuanced while all the advice one receives via healthcare influencers on social media and youtube speak with absolute certainty. People want certainty. They don’t like uncertainty. Unfortunately in medicine we’re almost always operating in the “grey” as very little is black and white. So people will trust the eloquent, confident, good-looking influencer over the less certain MD/DO.
I'm a retired ICU RN. My father and grandfather were MDs. I've lost my faith. How could I not? In Dec 2020 it was known the mRNA shots were not tested to see if they stopped transmission or hospitalization. Yet the PSAs, Fauci, and the medical community confidently proclaimed them "safe", "effective" and "the only way out." In June 2021 when I told my doctor I didn't want it because the platform had not been adequately tested and it looked like the spike was pathogenic, she looked confused and asked me if I had any specific questions. When I said, "Why are they censoring doctors?" she looked like she was considering a psyc eval so I dropped it. The mRNA platform and Spikeopathy are still an issue. Here's one older paper on this, in case someone is unaware. https://mdpi-res.com/d_attachment/biomedicines/biomedicines-11-02287/article_deploy/biomedicines-11-02287-with-cover.pdf?version=1718880673
Unforetunatly a post that says so many right things but is extremely US centered. Beside Sweden (about 0,12% of World population) nearly all other countries did similar procedures (which many of US claimed and claim as wrong). But for most of them they could not swim against the tide. Trust in medicine did not only declined due to RFK or Trump or US COVID policy. There are propably a very complex reasons why it is so, and we all should be humble enough that our small bubbles (California or Germany or whatever) are only little stones in a big picture
Agree agree agree!! Throughout it all the hypocrisy was evident. I am a family doc, was on the local school board during Covid, and was highly torn between trying to follow CDC guidance and the AAP and my own understanding and observation about mild illness and children, and the importance of people being together, particularly after the first two vaccines were widely taken up. I fully understand why people might not trust information coming from us or our government after that debacle, and I do agree that acknowledging where we may have been misled can go along way to helping people trust us again. Scientists are nothing if not people who are able to change their minds based on new information.
There were no experts during the pandemic. No one had experience with administering a novel vaccine platform against a novel virus during an active pandemic. None. Yet we failed to collect rigorous data during that time. I worked in public health then and pushed for that but was refused. Yes it was politicized. The Teachers Union fought the return to classrooms. No where are the unions more powerful than in California where the school system ranks lower than 40 out of 50. As to the California Medical Association, they are a feckless tool to the Sacramento agenda. They do not represent physicians. As to loss of trust in doctors we have to view it from a patient’s perspective. The majority of physicians in California are now employed by large hospital systems. That has resulted in no longer having control of the physician patient interface. Operations and policy is dictated to employed doctors by a corporate administration with a focus on ROI. The patient sees a huge health system made up of big buildings full of automatrons that churn them from one test or lab to another all within their self serving system. This same system failed to convey the nuance of COVID vaccines, prevention and treatment because they were controlled. It was bound to happen by design thanks to the ACA and to CMAs being in bed with the state government and not us. As mentioned the laws California passed during the pandemic that sought to silence decent or fire a HCW who chose not to get the jab were appalling. That shit is on CMA as much as it’s on Newsom or Biden.
Thank you for a well-written article. I didn't see a link to the California Op Ed article. I'd like to be able to read it for myself.
It seems almost everything has become politicized. We should be asking why we feel such a strong need to belong to and identify with a political party. What is missing in our lives? We no longer belong to social organizations in our community - all these social organizations are suffering from a lack of membership (church, Rotary, Freemasons, The Elks, etc.). Instead of belonging to a social organization that helps one's community, people are identifying with political parties.
Regarding Covid itself, I have an interest in the history of medicine. I believe distrust started long before Covid. At one time, doctors were revered; for the most part, patients accepted whatever they said. Heck, they used to give out pills without labels, hide diagnoses if they thought the patient couldn't handle it, and more. Physicians tend to talk in certainties, and rather confidently.
Distrust started once people started realizing that doctors were human (maybe it was TV shows like "ER"). The hypocrisy during Covid accelerated that distrust greatly. Then there were the statements, "follow the science" or the "the science is settled", that started during Covid. We all knew that the science was not settled; we are still learning. As we learn more, our understanding broadens, and recommendations change.
January 2023, my mother-in-law with COPD/HF in the second half of her 80's, was hospitalized. Medical staff told my wife they wanted to start Remdesivir. My wife knew two things. One, there is a statutory requirement for informed consent. She was provided with none. Two, the CDC and WHO had different perspectives on Remdesivir. My wife called her sister, an ENT, and they discussed their mothers condition. The condition including that their mother was tired of the disease, and most importantly, that they didn't know if she had covid or not. Together they decided against Remdesivir. The medical staff, more than once, told my wife, "If she dies, it's on you".
My mother-in-law was discharged from the hospital without a covid diagnosis and would live another 2-1/2 years. Trust lost.
There is an important distinction between physicians who care for individual patients and public health officials who develop policies for entire populations.
Most physicians are trained primarily to diagnose and treat patients, not to critically evaluate epidemiologic data or assess population-level policy decisions. Medical education places a strong emphasis on memorization and pattern recognition, while statistical reasoning and critical appraisal of the literature often receive far less attention.
As a result, many physicians rely heavily on clinical guidelines without fully understanding the underlying evidence, assumptions, and methodological limitations that shaped those recommendations.
It is relatively easy to create a workforce of physicians who can accurately recite guidelines. It is much harder to develop physicians who can independently evaluate the evidence, understand the statistical principles behind the recommendations, and recognize when guidelines may or may not apply to a specific patient or circumstance.
Thank you for a thought provoking article. It may be my age or life stage but after living through this I wonder if my love for, trust in, purpose in medicine has not been significantly eroded and somewhat dismantled. I am near retirement and prior to COVID My admiration for medicine was strong now I find it particularly in this country to be very skeptical. Perhaps it is a good thing and I should have been more skeptical previously. Either way it is what it is, and I work each day to be humble and develop trust with my patients individually which is hat each of us can do.
Yes, COVID was largely a mess. There is another reason the public should not trust the healthcare system. It completely missed the most common disease in developed cultures: https://carbsyndrome.com
This condition is triggered by the neurotoxic effects of ultra-processed foods, driving our twin epidemics of obesity and common brain disorders. It's easy to prevent or reverse if you know what to do.
Excellent piece. ER doc for 30+ years and worked through all of Covid. Could not communicate with the patients due to pappers, mask, garb, no visitors, patients couldn’t hear w no hearing aids, they couldn’t read lips, it was painful. One day made the executive decision took it all off and never looked back. Wore blue jeans, no mask, did every single procedure in our profession including airways without the nonsense. I never had so much as a runny nose, never tested positive ever, never missed one day of work through Covid nor in my entire career. Meanwhile, I had younger partners that called in sick because their cousin tested positive. Fools follow other fools off a cliff.
Medicine since then has not been doing a good job with “gender affirming” medication and surgeries either. The AAFP and others adopted the language, and even now, the number one thing that shows up under a patient’s name is “gender identity” in Epic. This is a radical adoption of an ideology and practice without much, if any, evidence on its side.
The go-along to get-along is partly to blame. The true experts are silenced while the charlatans are given the podium. How many instances of “ nutraceuticals “ claiming benefits on cholesterol or ED have been proven to have statins or sildenafil respectively and how were these companies sanctioned ? Are the three-letter agencies still trying to protect the public? $$$$$ makes monkey dance ?
On masking, a patient put it in very simple terms : “ you mean to tell me y’all are trying to keep mosquitoes out with a three strand barbed wire fence ? “
excellent piece right on! The problem with science is even the research , NIH,FDA and journals have now been compromised so its hard to evaluate data and trust anything you see ---
These are great points, but I think the problem runs much deeper. COVID policy nonsense has led more and more people to question the reliability of healthcare as a whole. What can we really believe? A team of scientists, including John Ioannidis, analyzed over 1,600 Cochrane reviews and found that only 5.6% of medical services can be shown to be effective, based on high-quality evidence. They also found high-quality evidence that 8.1% are harmful, possibly as high as 36.8%. Cochrane reviews are considered the gold standard in evidence-based medicine. The healthcare system is eroding the standard of living for the working class, taking almost 20% of our national income. And what do we get?
https://pubmed.ncbi.nlm.nih.gov/35447356/
I think he’s missing the larger point. The greatest reason people don’t trust medicine is because medicine is nuanced while all the advice one receives via healthcare influencers on social media and youtube speak with absolute certainty. People want certainty. They don’t like uncertainty. Unfortunately in medicine we’re almost always operating in the “grey” as very little is black and white. So people will trust the eloquent, confident, good-looking influencer over the less certain MD/DO.
I'm a retired ICU RN. My father and grandfather were MDs. I've lost my faith. How could I not? In Dec 2020 it was known the mRNA shots were not tested to see if they stopped transmission or hospitalization. Yet the PSAs, Fauci, and the medical community confidently proclaimed them "safe", "effective" and "the only way out." In June 2021 when I told my doctor I didn't want it because the platform had not been adequately tested and it looked like the spike was pathogenic, she looked confused and asked me if I had any specific questions. When I said, "Why are they censoring doctors?" she looked like she was considering a psyc eval so I dropped it. The mRNA platform and Spikeopathy are still an issue. Here's one older paper on this, in case someone is unaware. https://mdpi-res.com/d_attachment/biomedicines/biomedicines-11-02287/article_deploy/biomedicines-11-02287-with-cover.pdf?version=1718880673
Unforetunatly a post that says so many right things but is extremely US centered. Beside Sweden (about 0,12% of World population) nearly all other countries did similar procedures (which many of US claimed and claim as wrong). But for most of them they could not swim against the tide. Trust in medicine did not only declined due to RFK or Trump or US COVID policy. There are propably a very complex reasons why it is so, and we all should be humble enough that our small bubbles (California or Germany or whatever) are only little stones in a big picture
Agree agree agree!! Throughout it all the hypocrisy was evident. I am a family doc, was on the local school board during Covid, and was highly torn between trying to follow CDC guidance and the AAP and my own understanding and observation about mild illness and children, and the importance of people being together, particularly after the first two vaccines were widely taken up. I fully understand why people might not trust information coming from us or our government after that debacle, and I do agree that acknowledging where we may have been misled can go along way to helping people trust us again. Scientists are nothing if not people who are able to change their minds based on new information.
There were no experts during the pandemic. No one had experience with administering a novel vaccine platform against a novel virus during an active pandemic. None. Yet we failed to collect rigorous data during that time. I worked in public health then and pushed for that but was refused. Yes it was politicized. The Teachers Union fought the return to classrooms. No where are the unions more powerful than in California where the school system ranks lower than 40 out of 50. As to the California Medical Association, they are a feckless tool to the Sacramento agenda. They do not represent physicians. As to loss of trust in doctors we have to view it from a patient’s perspective. The majority of physicians in California are now employed by large hospital systems. That has resulted in no longer having control of the physician patient interface. Operations and policy is dictated to employed doctors by a corporate administration with a focus on ROI. The patient sees a huge health system made up of big buildings full of automatrons that churn them from one test or lab to another all within their self serving system. This same system failed to convey the nuance of COVID vaccines, prevention and treatment because they were controlled. It was bound to happen by design thanks to the ACA and to CMAs being in bed with the state government and not us. As mentioned the laws California passed during the pandemic that sought to silence decent or fire a HCW who chose not to get the jab were appalling. That shit is on CMA as much as it’s on Newsom or Biden.
Thank you for a well-written article. I didn't see a link to the California Op Ed article. I'd like to be able to read it for myself.
It seems almost everything has become politicized. We should be asking why we feel such a strong need to belong to and identify with a political party. What is missing in our lives? We no longer belong to social organizations in our community - all these social organizations are suffering from a lack of membership (church, Rotary, Freemasons, The Elks, etc.). Instead of belonging to a social organization that helps one's community, people are identifying with political parties.
Regarding Covid itself, I have an interest in the history of medicine. I believe distrust started long before Covid. At one time, doctors were revered; for the most part, patients accepted whatever they said. Heck, they used to give out pills without labels, hide diagnoses if they thought the patient couldn't handle it, and more. Physicians tend to talk in certainties, and rather confidently.
Distrust started once people started realizing that doctors were human (maybe it was TV shows like "ER"). The hypocrisy during Covid accelerated that distrust greatly. Then there were the statements, "follow the science" or the "the science is settled", that started during Covid. We all knew that the science was not settled; we are still learning. As we learn more, our understanding broadens, and recommendations change.
January 2023, my mother-in-law with COPD/HF in the second half of her 80's, was hospitalized. Medical staff told my wife they wanted to start Remdesivir. My wife knew two things. One, there is a statutory requirement for informed consent. She was provided with none. Two, the CDC and WHO had different perspectives on Remdesivir. My wife called her sister, an ENT, and they discussed their mothers condition. The condition including that their mother was tired of the disease, and most importantly, that they didn't know if she had covid or not. Together they decided against Remdesivir. The medical staff, more than once, told my wife, "If she dies, it's on you".
My mother-in-law was discharged from the hospital without a covid diagnosis and would live another 2-1/2 years. Trust lost.
There is an important distinction between physicians who care for individual patients and public health officials who develop policies for entire populations.
Most physicians are trained primarily to diagnose and treat patients, not to critically evaluate epidemiologic data or assess population-level policy decisions. Medical education places a strong emphasis on memorization and pattern recognition, while statistical reasoning and critical appraisal of the literature often receive far less attention.
As a result, many physicians rely heavily on clinical guidelines without fully understanding the underlying evidence, assumptions, and methodological limitations that shaped those recommendations.
It is relatively easy to create a workforce of physicians who can accurately recite guidelines. It is much harder to develop physicians who can independently evaluate the evidence, understand the statistical principles behind the recommendations, and recognize when guidelines may or may not apply to a specific patient or circumstance.
Amen!
Thank you for a thought provoking article. It may be my age or life stage but after living through this I wonder if my love for, trust in, purpose in medicine has not been significantly eroded and somewhat dismantled. I am near retirement and prior to COVID My admiration for medicine was strong now I find it particularly in this country to be very skeptical. Perhaps it is a good thing and I should have been more skeptical previously. Either way it is what it is, and I work each day to be humble and develop trust with my patients individually which is hat each of us can do.
Yes, COVID was largely a mess. There is another reason the public should not trust the healthcare system. It completely missed the most common disease in developed cultures: https://carbsyndrome.com
This condition is triggered by the neurotoxic effects of ultra-processed foods, driving our twin epidemics of obesity and common brain disorders. It's easy to prevent or reverse if you know what to do.