key: cord-0764143-xapz5u3o
authors: Tsagkaris, Christos; Moysidis, Dimitrios V; Loudovikou, Anna; Papazoglou, Andreas S
title: Patient trust amidst the COVID-19 pandemic: a Greek experience
date: 2021-07-02
journal: Ethics Med Public Health
DOI: 10.1016/j.jemep.2021.100701
sha: aa51513ff9f1fe823d530bf051cdc9f70a6a9164
doc_id: 764143
cord_uid: xapz5u3o

nan

A young man presents in the emergency department with a wryneck. Wryneck, or torticollis, consists of a benign yet burdenful musculoskeletal condition of the neck.

The physician on call provided the man with a reliever and referred him to the outpatient clinic. The man sighed complaining that he has been visiting emergency departments for weeks unable to get proper treatment, due to the suspension of more than 80% of outpatient clinics' capacity during the COVID-19 pandemic. The physician explained the situation to the man, but was unable to inform him whether he would be able to reserve a consultation [1] . The incident happened in Greece, a member state of the European Union (EU) with one of the highest numbers of doctors per capita in the western world.

The experience of this man reflects an emerging gap in doctor-patient trust during the COVID-19 pandemic. Patient satisfaction has reached unprecedented lows in many countries. According to a recent study, the liability charges in the UK have exceeded £78 billion during 2020 [2] . This is an indirect yet quantitative metric of the mistrust ravaging doctor-patient trust. Trust matters right now because patients are an essential part of COVID-19 response. Their adherence to protective measures and vaccination campaigns is essential to mitigate the forthcoming waves of the pandemic, and obviously, adherence is a matter of trust [3] . Therefore, bridging this gap is crucial for the COVID-19 response. To rebuild doctor-patient trust amid the pandemic, three steps are necessary under the European "act-react-impact" strategy [4] . So far, the EU has deployed such strategies, in order to address severe issues such as the so-called democratic deficit within the EU administration [5] . Can this strategy be adapted to doctorpatients trust? Act pertains to action for non-COVID-19 patients, with limited J o u r n a l P r e -p r o o f 3 access to healthcare. Globally, patients with cancer have experienced delays in screening, follow-up or treatment. Patients with cardiovascular disease were unable to reach a doctor despite the deterioration of their symptoms, patients with low back pain endured pain and move limitation on their own. Doctors were not (able to be) there in the time of need, and this absence has alienated the patients from them [1] . Maintaining non-COVID departments and providing adequate and timely care to patients with recurrent chronic conditions is a prerequisite for trust. Additional personnel and resources are required. Using public buildings as outpatient clinics in a safe distance from COVID-19 wards-and staffing them with healthcare workers of all specialities, is equally important to manning COVID-19 departments. This is not a comparison between diseases but a way to increase patients' safety. The reaction consists of adaptation to the pandemic. Telehealth has thrived during the last months, and in many cases, it has achieved comparable results to physical consultations. Although the man with the wryneck would most likely need a physical outpatient consultation, he would be more than happy if he managed to have a video call with a doctor and an online prescription of appropriate examinations and drugs. A caring voice on the other side of the phone would inspire more trust rather than self-rushing to and waiting in an emergency department close to potential COVID-19 cases. The infrastructure for telehealth is already here grace to contemporary telecommunications. However, confidentiality and safety issues still need to be addressed by stakeholders and policymakers. Solutions include but are not limited to revamping the general data protection regulation (GDPR) in a health context or employing disruptive encryption technology such as blockchain [6] . The latter would help to rebuild trust in telecommunications and social media encryption methods, although this issue is beyond treating the wryneck and the twisted doctor-patient faith. Impact pertains to There are multiple prevention strategies for life threatening and debilitating diseases, such as hypertension, coronary artery disease, musculoskeletal injury and cancer, among others [7] . In a population with a lower prevalence of preventable diseases, the wryneck patient would not have to wait for so long to reserve a consultation even during the pandemic. Having familiarized the population with health promotion strategies, more individuals would adhere to COVID-19 measures, decreasing the burden of hospitalization and enabling the healthcare system to keep treating all conditions including wryneck. Overall, doctor-patient trust has been shaken during the COVID-19 pandemic. Neglected conditions have raised dissatisfaction among patients, while doctors have been overwhelmed with the surge of COVID-19 cases. A three-level approach ensuring that no-one is left behind in the short term and that people will be healthier in the long term can open a new chapter in doctor-patient trust.

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Has the covid-19 pandemic changed the doctor-patient relationship forever? -The BMJ

Doctor-patient relationship at the time of COVID-19: travel notes

Act React Impact | News | European Parliament

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