One consequence of the COVID-19 pandemic is the continued erosion of trust in health care, a growing rift between doctor and patient epitomized by large numbers of people who hesitate or refuse to be vaccinated against the virus.
“Two years ago, we were front-line heroes,” Anil Trindade, MD, a pulmonologist in the Lung Transplant Program at Vanderbilt University Medical Center, said during a panel discussion at VUMC on May 11. “How did we get to a point where we’re so reviled by segments of the population today?”
The Ethics Grand Rounds, sponsored by the Vanderbilt Center for Biomedical Ethics and Society, explored potential ways to improve vaccine readiness and restore trust in health care providers.
“Health care professionals and institutions must be trusted,” said panelist Allison McCarthy, PhD, assistant professor of Psychiatry and Behavioral Sciences at VUMC and a core faculty member in the Center for Biomedical Ethics and Society.
“We must consider strategies for how we can cultivate people’s confidence in our commitment to the promotion of patient well-being,” McCarthy said. “Only through these efforts and others will we be in a position to restore and reinforce this indispensable feature of the work of providing health care.”
Trust in health care has been declining for years, reflecting acceptance of the business model of health care delivery, the rise of patient empowerment and technological advances including telemedicine that some patients may consider impersonal and “faceless,” said Trindade, assistant professor of Medicine at VUMC.
Add the sudden appearance of a potentially fatal virus, coupled with constantly changing and, at times, conflicting public health messaging as new information about COVID-19 became available, and the confidence gap has widened even further, he said.
“There is no easy solution for this,” said panelist Jennifer Erves, PhD, MPH, MEd, associate professor of Internal Medicine at Nashville’s Meharry Medical College. As a start, however, health care must engage with the community.
“Just show up,” Erves said. “We have to meet people where they are.”
Panelist Isaac Thomsen, MD, MSCI, associate professor in the Division of Pediatric Infectious Diseases at VUMC, said it helps to understand the fundamental issues that drive vaccine readiness.
If parents express concern about exposing their children to an “impure” vaccine, Thomsen said he may respond, “Let me tell you what I view as horribly impure, and that is this virus. Let’s put a force field around them. Let’s protect them with these vaccines.”
Crafting messages that address individual concerns can be effective, but it takes time. “If I have an hour, I can usually get someone to vaccinate their kids,” he said. “Ten minutes is not going to be enough.”
One possible solution: provide vaccine information prior to a clinic visit and give patients or their parents time to discuss it with their doctors and other health professionals.
“People want the time to talk about these things so they can make an informed decision about getting the vaccine for themselves — or their children,” Erves said.
