Understanding Americans’ Rampant Dissatisfaction with Healthcare

“As a patient, I do not want to hold hands with a robot and confide my health problems to a faceless entity. As a doctor, a patient, and a human being, I reject the currently shattered doctor-patient relationship.”

Healthcare in the United States is upside down. It tends to serve an “administocracy” at the top, with the patient at the bottom. This situation is not as it should be—or could be. We must, therefore, work together to turn healthcare right side up with the patient—with all of us—as the ultimate benefactor.

I have been a doctor for 60 years. During these years I have also, at times, been a patient. I have held the hands of my patients; I have been the one whose hand was held. I have received trust and given trust. The therapeutic decisions my patients and I reached were not previously subject to the interdiction of a third party. Now, I do not want to have my life’s role as a physician and surgeon—and my joy in the process—usurped by an administocracy. As a patient, I do not want to hold hands with a robot and confide my health problems to a faceless entity. As a doctor, a patient, and a human being, I reject the currently shattered doctor-patient relationship.

The inspiration to write my new book Healthcare Upside Down emerged from my six decades as a doctor and surgeon. I have witnessed dramatic changes in healthcare and its delivery since when I began. The standard global statistics, which are the undeniable facts of healthcare, offer compelling evidence that we are far from providing for our population what other countries provide. In every measurable category of healthcare—life expectancy, mortality rate, potential years of life lost, infant mortality, amenable mortality to healthcare, and healthcare access and availability—we rank below every Western European nation, Australia, New Zealand, and our neighbor Canada. We are number one in a single category: healthcare costs, where we exceed every nation, by spending 17.8% of our Gross National Product on this sector. Even with that degree of spending, Americans are not particularly satisfied with the healthcare they are receiving. A January, 2023 Gallup poll found that less than half of Americans consider healthcare in the United States as deserving of the descriptors “Excellent” or “Good.”