Trust Is What We Need by Paul Pender, MD

(The following Letter to the Editor was submitted on December 21, 2020.)

The December 15, 2020 edition of the JAMA Network has seven articles on the subject of trust. The challenge for physicians post-pandemic is to focus on what we can accomplish as individuals and on what goals for our profession, and for society in general, we should set. The prioritization of various groups for the coronavirus vaccine reflects both the practical need to protect healthcare workers and the recognition of those who are most likely to suffer serious health consequences from infection. The input from the National Academy of Sciences, Engineering and Medicine walked a fine line between medical ethics and political correctness in its Framework for Equitable Allocation of Vaccine for the Novel Coronavirus. Claiming that “systemic racism” is responsible for health disparities and the greater death rates from COVID-19 among people of color does a disservice to those who, in good faith, work every day for the health of all Americans, regardless of their economic, racial or ethnic status. Physicians take the Hippocratic oath to treat all comers. In the past, regrettable government experiments withheld treatment of black sharecroppers to see what the natural history of syphilis would show. Such actions are unconscionable and deserve condemnation. But let’s not condemn the entire medical profession for these sins of the past.

Trust is hard to gain and easy to lose. An honest assessment of the risks and benefits for the recently released vaccines has been provided by government officials at the highest level of public health and safety. The FDA has given emergency use authorization to two companies for the production and distribution of vaccine, and more may come. The FDA is, by nature, risk-averse to rapid approval of drugs and devices. The evidence for safety and efficacy was overwhelmingly positive for the Pfizer and Moderna vaccines. It helped that healthcare workers and government representatives from both sides of the aisle were filmed receiving the coronavirus vaccine. Setting such an example for others to follow is good policy.

By historical standards, the coronavirus vaccines were developed and distributed in record time. Perhaps these events will help to rebuild some of the trust that we all need.

Paul Pender, MD practiced clinical ophthalmology for 38 years. He is the author of Rebuilding Trust in Healthcare: A Doctor’s Prescription for a Post-Pandemic America, Early Arrival Press, 2020. He serves as an advisor to Vxtra Health. Contact: