re: The Atlantic really mad at Twitter. They have no answer for #DiedSuddenly.

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This is true of my experience as well that the online skepticism is far and away greater than in clinical settings, though the setting is going to make people more reticent. You'll also have a selection effect where skeptics are less likely to seek care, but it seems like a portion of it is that the skepticism is an identity-badge for signaling online in ways people will recognize leftward folks of doing to signal deference to medical authority (it's easier to see outgroups behaviors this way).

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Because y’all live in a bubble. I can assure you that a patient isn’t going to tell a doctor who they’re having to entrust with their life exactly what they think of the people in their profession.

My daddy had major surgery last week bc of blockage in his carotid arteries. He wanted to tell them he only wanted blood from donors that didn’t have the covid shot if there was an emergency and he needed a transfusion. I told him that I don’t trust the doctors to not intentionally do something spitefully. We agreed to just not say anything bc we fear spiteful retribution.

I’m sure his vascular surgeon thinks his patients have so much trust in him as well. Quite the opposite…. We’re so distrustful that we fear telling them how we really feel.

Just bc a patient doesn’t tell you that they think y’all are full of shite to your face, doesn’t mean they trust what you’re telling them. The majority are like my dad and don’t have a choice but to still continue getting healthcare.

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It might be true for early in the pandemic, but I can’t speak to what floors were like then.

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In an environment of questionable Vax efficacy, Vaxxed vs Unvaxxed infection proportions assume more importance. Anything to add in terms of anecdotal hospitalizations/outcomes of those two categories?

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Vaxxed vs Unvaxxed infection proportions assume more importance.

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I couldn’t tell you those proportions off the top of my head and without looking at the charts. It’s probably more vaxxed than unvaxxed, just going by the relative rarity we see younger patients admitted for COVID. If the old vaccine tracker is to be believed, the patient cohorts more likely to suffer from serious illness due to COVID are also the groups, above 50 y/o’s generally, who are vaccinated at a high rate.

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I’m certainly not denying that there is a large degree of overall skepticism, but I’m skeptical to the degree which it will matter in face to face interactions. Or rather, that the philosophy of distrust has a method of actually putting it into practice.

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The setting and the acuity and severity of illness may make a difference between what inpatient and outpatient docs see (I haven't done anything inpatient in >10 years). I generally expect more severe symptoms and worse prognoses to engender more health-related anxiety which in turn lowers the threshold for trust and deference to authorities that they might be otherwise be more skeptical of.

It's sort of akin to the "no atheists in foxholes idea" and makes me think of a family story. My great-grandfather who did country medicine used to see patients out of his house in South Louisiana in the first half of the 20th century and my dad remembers him telling stories of having Christian Scientists who would never treat the country doctor with respect in public come to the back-door to get their care when they were sick enough.

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Carry on with your TigerDoc circle jerk about people who don't exist, or maybe they only exist online; I'm not sure what you currently believe. Nor do I care at this point.

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They do exist, but there's all sorts of context-dependent factors that factor into how their beliefs are cashed out in behavior, baw. People here accept pretty unremarkably that virtue signaling exists and it exists in this realm too.

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more health-related anxiety which in turn lowers the threshold for trust and deference to authorities that they might be otherwise be more skeptical of.

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I'm not sure that follows, at all.

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I don't know of a single case, besides one old man who died the week after he was vaccinated with his first dose, but he had covid, too.

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If deaths among 40 year olds was up 100% you probably wouldn’t notice.

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I'm not sure that follows, at all.

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I think it absolutely does, but it undermines the point his cohort was trying to make.

If you're a single mom and the local mechanic is shady, you may avoid him as best you can. Check engine light comes on, you put it off. Tire a little out of balance, same thing. But if your car stops running you're going to go to the shady mechanic. That doesn't mean you suddenly think he's trustworthy, it just means he's the best current option.

The specific point I was exploring was to offer a hypothesis about how to explain differences in expressed distrust we encounter in different settings. Outpatient docs have a trust advantage in being able to establish a relationship over time, but they often deal in primary prevention sorts of interventions like vaccines where the benefit is more abstract. Vaccination is interesting from a signaling POV, because if you belong to a vaccine-skeptical community, it's relatively cheap to express skeptical sentiments but it's really hard for others to know if you've lived that in your choices and so if your doctor convinces you to try it, you might want to hedge and be vaccinated and say you haven't.

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Vaccination is interesting from a signaling POV, because if you belong to a vaccine-skeptical community, it's relatively cheap to express skeptical sentiments but it's really hard for others to know if you've lived that in your choices and so if your doctor convinces you to try it, you might want to hedge and be vaccinated and say you haven't.

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You live in a strange world. That's just not a topic that comes up socially in my circles, and if someone volunteers the information nobody GAF one way or the other.

You're also missing the gap between someone's personal provider and someone like the head of the FDA or CDC, or even some local AMA org. If someone has a primary provider odds are they trust them; that says nothing about their trust of other authorities.