#1 Myth About Medical Mistrust

Medical Mistrust (mm) is apprehension characterized by a person’s (or group of people’s) lack of confidence, fear or vulnerability associated with their engagement with medical professionals and/or care provision systems. It is a natural, human reaction related to one’s exposure or lack of exposure to experiences, information, education, socioeconomic status, and other social determinants of health.

Contrary to the messages embedded in mainstream social design and accepted behaviors, our health is our most important status. Far more important than how much money we have, what we look like, who we know or any of the many things we prioritize over it. It has been said that “feeling good [as a result of good health] beats any amount of looking good,” and there are no exceptions in person, status, or geography. Our health should be our number one priority and we should use every tool available to us to promote the maturity of a public environment that supports good health through healthy living (vs. the use of medications).

But what does a person do when their reality or their environment is unhealthy? What do they do when they do not have easy access to nutritious food options? How might a person feel when they enter a health care facility only to face the reminders of disparities? In many cases, long before making an appearance at a health provider, some people face the tough challenge of how they will get there. Yes. These too add to our anxiety and promotes mm.  Imagine a person trying to focus on their health when first they must overcome questions about why their journey to needed support is so complicated. These are subtle influences that impact momentum in the pursuit of good health. And all this matters. While it may not seem immediately apparent, all the issues I raise here are factors and independent variables associated with, influencing, and impacting mm. In aggregate, researchers and medical professionals refer to them as social determinants of health.

Medical Mistrust is justified. Allow me to provide context. Would anyone blame a person’s lack of confidence in another, if two or more people who were engaged in a marriage, business partnership or any other important collaboration, endured repeated disappointment through infidelity, theft, or any infraction of their arrangement? Do we fault the spouse who does not trust a cheating partner (assuming you correctly understand their arrangement)? No.

While many efforts to abate mm are focused on the health consumer, this is errant. The issue is not with the health consumer, it is with the healthcare system.

Just as we do not fault the spouse in my context scenario, we cannot fault the health consumer engaged with a healthcare system that commits “medical infidelity” – maybe, the system is perceived as being focused on profits more than the outcomes of its patients. Or maybe, the healthcare systems are mismanaged, failing to modernize their approaches, facilities, or business model etc.

Explained differently, if a person is apprehensive about undergoing a major surgery, that is smart and prudent. The risks associated with surgery are real. However, if a person is apprehensive about undergoing surgery because they believe that the doctors are only suggesting it to earn money, that is a problem. Having concerns about the risks is healthy. Having concerns about the intent of the doctors is medical mistrust. Medical mistrust is a care delivery flaw, not an issue of non-compliance or non-cooperation on behalf of the patient.

Now that this myth has been exposed, let us roll up our sleeves and begin the challenging work of addressing the real problem – our outdated healthcare provisions systems.

-MJH