Patients who are openly skeptical of a physician's science-backed advice

I’ve just passed the 15-year milestone of practicing family medicine in a small farm town in the Midwest. Knowing my patients and their multi-generational families deeply and enjoying their trust is a major part of my job satisfaction.

Unfortunately, the last two years have put a serious dent in both the trust and the satisfaction.

No one ever takes all the advice their physician gives them, at least in my experience. Until recently, however, I had not met such doubt and skepticism toward my medical knowledge and advice.

Sure, there were scattered vaccine, statin, or SSRI resistance instances. Sometimes the person would stick with me, and we would have serial conversations on the topic. Other times they would wander off and seek care elsewhere. No hard feelings.

Now it’s different. Before 2020 it was maybe one in 100; now, it’s one in three who are openly skeptical of my science-backed advice.

Many of these people have trusted me with their children, spouses, and parents for years. Now, what they hear or read on the news or social media is more impactful and apparently trustworthy than their doctor.

I spent about a year hitting my head against the wall with many of them. Our blood pressures would rise in tandem, and I could often feel the relationship start to fray even further. Occasionally, I would even get blunt and ask why they were still coming to me and paying their co-pay when they felt so doubtful about my advice.

What to do? It’s easy to find a family medicine job; maybe I should practice somewhere with different news and social media viewing habits. Even completing the thought breaks my heart. These are my people. I grew up in a very similar town. Until recently, I felt completely comfortable with the thought of a 30-year career in the same old building.

Now? I’m blue.

Exhaustion and cynicism, and even depression battle for headspace. Some days it feels like a battle with myself just to show up and be “on” and present.

Where does it go from here? I really don’t know. Fifteen more years like this seems incredibly daunting.

Watching my new partner helps, honestly. Fresh from training and knowing no other world, Dr. S is an inspiration to the mid-career muddle I’m in.

Maybe this is as good as it gets anymore, I don’t know. Maybe avoiding politically hot topics and coaching a new grad into maturity will be enough to sustain me.

I guess we’ll see.