Healthcare vs. Public opinion: How should we navigate and address hesitant population

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This article was exclusively written for The European Sting by Mr. Martin Duranik, a 3rd year medical student at Pavol Jozef Safarik University, currently serving as VPE SloMSA Slovakia. He is affiliated with the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writers and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.


Covid-19 struck the world by surprise, exploiting all the gaps in preparation and self-proclaimed invincibility against such threats. There is no doubt that the world has been changed profoundly by this terrifying experience. And it is not only the aspect of physical health – a profound change happened in perspective of healthcare. We came from a doctor-patient relationship to public discussion.

 First, we must rethink this approach. The doctor-patient relationship has been defined as “a consensual relationship in which the patient knowingly seeks the physician’s assistance and in which the physician knowingly accepts the person as a patient.” (1) But why should we stress it so much? While public discussion may be the most precious and valuable interaction of free society, it is not fitted for pursuit in fulfilling the needs of an individual with underlying global health context. Large quantities of accessible data, especially on the internet, may cause confusion even to the experts, let alone to the general population. This is quita essentia of the hesitancy itself. Mistaking the authority of an expert in his field, for individuals seeking recognition can be prevented by shifting conversation from public space back to doctor’s office.

However, to be trusted, we should spend some of our energy trying to create comprehensive guidelines for doctors themselves. Any doubt of an expert projects negatively on a patient and undermines the trust between the two. During pandemic, even if created, they offered great space for potential confusion and uncertainty – leaving doctors alone to decide on a greatly socially discussed matter. Particularly vulnerable is the older generation of healthcare professionals, more rigid in an online environment, who provide care for patients in mostly rural areas. (2) These areas are vital for successful vaccination coverage, as while in urban areas vaccination rate surpasses 75%, in rural areas it is no more than 59%. (3)

Furthermore, resources dedicated for vaccination awareness should be aimed at hesitant audience, not the denying one. Slovak survey found out that just 20% interviewed are explicitly against the vaccination, while almost 50% is being hesitant. (4) The ongoing attempt to persuade the antivax community seems long, expensive, thus inefficient. Even worse, the sense of urgency and pressure by the government, that is already often distrusted, is misused to support the anti campaign.

To conclude, our aim in successfully overcoming the hesitancy in vaccination should consist of effectively targeting the right demographic, accepting the proposal made by vaccine opposition and stripping the government from interfering in public vaccination campaigns. Instead, it should lay out exact guidelines for doctors to follow, strengthening the doctor-patient relationship and ultimately stabilizing ongoing fracturing of our society. IGOs and NGOs should keep on their work of raising awareness among the population. This may lead to separation of government and other organisations being seen as one, thus not burdening them with other, no health-related discussions. If done correctly, we could get to the same universal acceptance of vaccines, as we had before covid antivax campaign.

References:

1. QT, Inc v. Mayo Clinic Jacksonville, 2006 US Dist. LEXIS 33668, at *10 (ND Ill May 15, 2006)

2. Palmer, John. “As Rural Docs Age, Will There Be Enough Left?” Patient Safety & Quality Healthcare, 6 Sept. 2019, https://www.psqh.com/analysis/as-rural-docs-age-will-there-be-enough-left/.

3. Saelee R, Zell E, Murthy BP, et al. Disparities in COVID-19 Vaccination Coverage Between Urban and Rural Counties — United States, December 14, 2020–January 31, 2022. MMWR Morb Mortal Wkly Rep 2022;71:335–340. DOI: http://dx.doi.org/10.15585/mmwr.mm7109a2external icon

4. IPSOS s. r. o: „TLAČOVÁ SPRÁVA: NA SLOVENSKU BY SA DALA PROTI VÍRUSU COVID-19 URČITE ZAOČKOVAŤ MENEJ NEŽ TRETINA POPULÁCIE, TÝCH, KTORÍ VAKCÍNU ZÁSADNE ODMIETAJÚ JE ALE EŠTE MENEJ. V KRAJINÁCH, KDE SA UŽ OČKOVALO OCHOTA STÚPLA.“ 11. 1. 2021. https://www.ipsos.com/sites/default/files/ct/news/documents/2021-01/ipsos_prieskum_ockovanie_proti_covid-19_tlacova_sprava_11._1._2021.pdf

About the author

Martin Duranik is a 3rd year medical student at Pavol Jozef Safarik University, currently serving as VPE SloMSA Slovakia. Having started in SCOME local activities, later engaging in student evaluation process and accreditation, he is also a member of Slovak Student Council for Higher Education. He took part in preparing a SSSF´s (IPSF) statement for the European Commission about low uptake of COVID-19 vaccines. His hobbies are philosophy, extensive discussions on coffee industry and karaoke parties.

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