John J. Ryan: Losing respect for health care workers endangers us all

No one would tell a NASCAR driver that they are using the wrong kind of fuel.

(Rick Bowmer | AP photo) In this April 30, 2020, photo, health care workers look on during a flyover at the University of Utah Hospital in Salt Lake City.

When the COVID-19 pandemic started, health care workers were almost universally celebrated as heroes. On a nightly basis people were opening their doors and windows to cheer and clap for those working on the front lines. We even had flyovers and Lady Gaga arranged a six-hour concert for us.

Now, almost two years into this crisis, the antipathy and mistrust towards physicians, nurses, physician assistants and others have reached a level that has started to harm health care delivery. The consequence of this will be to worsen the health of the nation.

The demand for ivermectin to treat COVID-19 infections is just an example of the shift in attitude towards health care workers. Throughout the country lawsuits have been filed against practitioners asking judges to intervene and have ivermectin administered to patients with COVID-19. So far, the judiciary have preserved the rights of those treating patients with the chief justice of the Texas appellate court writing, “Judges are not doctors. We are not empowered to decide whether a particular medication should be administered.”

There is no lack of empathy among those working at the bedside to family members who want to do everything for their loved ones. But the constant battling and belittling is exhausting, contributing to professional burnout which has now resulted in a nursing shortage across the country.

Many have argued that this increasing lack of respect and dismissive attitude towards the opinions of health care workers is a result of an increasing anti-science and anti-expert sentiment. However, the anti-science rhetoric is more selective, largely targeted at medicine, with the conversation being manipulated by those speaking from the loudest pulpit.

Take, for example, NASCAR. Most people like NASCAR, or at least respect the science behind it. No one would dream of approaching a NASCAR engineer and informing them that “I have done my own research, and you should use diesel to power your engines.”

NASCAR uses higher octane grades (98) than diesel (25) or even pump gas (87) because their engines have higher compression ratios, which yield more power in their racing engines. No one would say, “You might have a different opinion, but I think diesel works better in a NASCAR engine.”

The science is clear. The engineers are trusted. But there is also no large, concerted movement among public figures or Facebook groups targeting NASCAR engineers and asking, “What aren’t they telling us?” when it comes to their fuel choices.

The numbers protesting vaccines and mandates continue to grow and involve many health care workers themselves. This shift from being health care heroes has significant health implications on a larger level, in addition to the work force shortages. It undermines public health advice, most obviously other vaccine recommendations, which were already teetering on the appropriate levels of herd immunity.

It discourages direct patient contact, with a lot of health care providers opting to shift away from bedside care to background administrative work. And, as seen in the airline industry, the natural history of vitriol is to escalate resulting in physical harm to those doing their best to do their jobs.

There is no doubt that the movement to patient-centered care in recent years has been an important, positive shift which has raised the quality of care in medicine and improved outcomes. Indeed, the University of Utah has been at the forefront of this movement.

However, there is a difference between patient-centered care and patient-directed care, the latter of which undermines health care providers and could eventually put lives at risk.

John J. Ryan, M.D.

John J. Ryan, M.D., is an associate professor in the Department of Medicine, and director of the Pulmonary Hypertension Comprehensive Care Center, at the University of Utah.

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