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Doctors Are Just as Frustrated as You by Our Messed Up Healthcare System
Trust between doctors and patients is fraying, but there are ways to mend it
By Clare Ansberry, WSJ
March 22, 2025 8:00 am ET
Doctors have a message for patients: Trust is a two-way street.
A recent Turning Points column discussed patients’ eroding trust in doctors, who for better or worse, are the front face of the healthcare system. Readers shared stories of rushed appointments, disjointed care and communication breakdowns.
Doctors responded, and they have trust issues too, including with patients.
While some may see the response as defensive, it speaks to growing frustration on all sides with a system that has become cumbersome, costly and aloof. Healthcare in the U.S., it seems, pleases few and the bond between doctors and patients is fraying—although doctors hope to keep it from breaking.
One of doctors’ biggest gripes: largely corporate institutions that effectively set patient quotas and require extensive documentation. One physician said he and other doctors are allowed 15 minutes with patients; exceeding that leads to poor performance reviews and “being out of compliance.”
These doctors think patients lose trust because they don’t understand who or what is in control. “Physicians have lost autonomy,” says Dr. Corinne Rao, an internal medicine physician and hospitalist. “Their decisions are subject to the financial interests of their employer.”
Doctors also say that trust—and respect—go both ways. “It’s like a marriage,” says Dr. James Schouten, a family physician. Each side has to give 100%. Implying that a loss of trust is entirely the doctor’s fault, he says, suggests the patient has no role in establishing or maintaining trust.
They do, he and others say.
“Patient honesty is a big problem,” says Dr. John R. Bettinger, a gastroenterologist. Some patients don’t tell the truth about how much they drink and exercise, whether they use cannabis and follow through with treatments. Symptoms may have started six months ago, but they’re embarrassed they didn’t come earlier and so they say that symptoms started two weeks ago. That misleading information can affect a doctor’s diagnosis.
Another trust issue involves patients not following treatment plans, an issue that predated the pandemic but was exacerbated by it, say doctors and patients. A person stops taking a prescription because it caused an upset stomach. They mistakenly believe an infection is gone and toss their antibiotics. They quit physical therapy after two sessions, saying it didn’t work.
Patients don’t always tell their doctors they have changed course, which can hamper recovery. Dr. Brent Baranko, an orthopaedic surgeon who has been in practice for 30 years, says exploring options is important to build and maintain trust.
If a truck driver tells him he is on the road and can’t regularly do physical therapy, Baranko shows him exercises to do alone. They talk about steroid shots to alleviate pain. “We engage in shared decision-making,” says Baranko.
Another cause of eroding trust on both sides: unreasonable expectations. Some people expect or want an immediate diagnosis and simple resolution, without a lot of medications and surgeries. When that doesn’t happen, they blame the doctor. Doctors recognize a family’s pain and heartache, but feel second guessed.
Bettinger, the gastroenterologist, has in the past responded to unreasonable expectations by saying something like “I don’t have a magic wand,” which he realizes is a mistake. A better response, he says, is “This will take time to sort out,” or “I can’t cure this but I can keep it in remission.”
Increasingly, people are turning to online sources for diagnosis and treatments, which can affect trust. Doctors, for the most part, don’t mind and even encourage people to educate themselves with reputable and research-based online resources.
It gets problematic—and erodes trust in a patient—when the office visit becomes adversarial, says Schouten. The family physician says he is sometimes forced to justify why his 20-plus years of experience gives him a perspective that Google doesn’t.
Fixing what both patients and doctors describe as a broken healthcare system will take time—assuming it even happens.
In the meantime, doctors and patients can take steps to bridge the trust and respect gap. Bettinger, the gastroenterologist, for example addresses all patients by their last name, a sign of respect.
Dr. Charles Anderson, an internist in primary care, suggests patients write down their symptoms and concerns and prioritize them. “Going in prepared is the best advice I can give,” he says.
The best thing doctors can do is give patients their full attention. Time with patients is precious, he says, so make the best use of it. “Turn away from the computer screen, sit down and ask them “What is really important to you?”
Meet patients where they are, says Dr. Ricky Haug, who owns a direct primary-care practice, which gives him more time to spend with each patient. Someone with diabetes who weighs 300 pounds isn’t going to immediately change their diet and go for a run every day, he says.
Patients lose trust when they feel like the doctor is lecturing them. “Will they always do what I recommend?” he says. No, but Haug says they are able to have an honest conversation.
Longtime patient Jeremy Smith also has advice. He was diagnosed with a rare blood cancer 36 years ago and told he had 10 years to live. In the decades since, he has had another blood cancer and heart disease, and assembled a team of oncologists, hematologists and cardiologists.
He has argued with them, challenged them, disagreed and agreed with them. They have encouraged him to ask questions and do research and counted on him to do his part in terms of diet, exercise and treatment.
“I have to trust my doctors and they have to trust me,” he says. “It’s all about communication.”
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