Trusting Your Doctor to Stop Ebola

A surprising amount of support for Texas Health Presbyterian Hospital, which made at least one major error in the handling of its Ebola case, reveals why we trust medical institutions so much.

Reading the comments on its Facebook page, you’d think Texas Health Presbyterian Hospital handled its Ebola case flawlessly.

“God bless the staff and patients at Texas Health Presbyterian Hospital in Dallas, Texas,” wrote Tracy Knollin Thorson. “I've been treated there many times and my parents have had multiple surgeries there. Nothing but the best care was given. The scrutiny they are under must be overwhelming.”

“This is very sad, but I'm confident that Presbyterian did everything possible,” added Debbie Steiner Wells.

But as we now know, the hospital did not do everything possible. When Thomas Eric Duncan, the man who died of Ebola there this week, first sought treatment for a fever and abdominal pain on September 25, he was evaluated by the hospital’s staff extensively. According to a statement by the hospital, the initial visit included “a four-hour evaluation and numerous tests.”

However, this battery of tests did not include the one for Ebola. The fact that Duncan had recently arrived from Liberia—a red flag that should have prompted his doctors to suspect the hemorrhagic virus—somehow did not get relayed to all of the providers treating him that day. Instead, he was sent home to his fiancee’s apartment, where he got sicker and potentially exposed up to 50 other people. He returned to the hospital and was placed in isolation on the 28th. He died there on Wednesday.

To be sure, on Facebook, the hospital’s blunder was brought up by several critics: “I am sorry for the family and their loss,” Pam Loh-Stuck wrote. “It's too bad he couldn't have been sent to Atlanta or Omaha where they know how to treat this deadly disease ... I hope the family sues the hospital and the city for the way they were treated.”

But surprisingly, the detractors were matched by a robust group of supporters.

“I have been treated at that hospital,” wrote Paul Adams in response. “The staff are consummate professionals and I am sure with the eyes of the whole world watching they did everything they could to keep him alive.”

The hospital had also bungled its explanation for Duncan’s ordeal, first blaming the mistake on their electronic health record, and then directly reversing that claim.

As Dallas Morning News editorial writer Tod Robberson pointed out, “At least one person possessed information crucial to a patient’s survival ... Thousands of people have survived Ebola, and Duncan should have been among them.”

This did not faze a woman named Barbie Monte, who wrote on the hospital’s page:

“Thank you for the services you provide! God will see your facility through the ridiculous finger pointing and rude comments! Good job!”

I’m sure there are a few naked-selfie-sending politicians out there who would kill for this hospital’s Facebook fanbase.

So why are people so sympathetic to a hospital that made an egregious—and possibly fatal—error involving a highly contagious virus?

Whether deserved or not, medical workers are often crested with a moral halo, as anyone who watches TV dramas or follows celebrity physicians like Dr. Oz probably knows. Nurses, doctors, and pharmacists regularly rank in the top five “most trusted” professions in the U.S., according to an annual Gallup poll. (The other two are soldiers and elementary-school teachers.) People trust their doctors even if they’ve been harmed by them, and they’re less likely to spend time vetting a new surgeon than they are a new employer or new car.

The rise of online health portals hasn’t shaken the public’s confidence in physicians. A 2010 New England Journal of Medicine survey of 16,000 people over seven years found that as the Internet became more popular, people trusted doctors more and the Internet less.

Medicine is expensive, and studies show people—sometimes irrationally—overvalue costly goods and services. You spent thousands getting Grandma’s tumor treated at Presbyterian, so why besmirch the place now?

Harvard professor Francesca Gino has shown that people are more likely to take advice that they’ve paid for. She’s also found that when we feel anxious—like, say, about Ebola—we’re more likely to seek out and take others’ advice. Medical advice happens to be something that’s pricey and worry-inducing enough to go unquestioned.

What’s more, healthcare is a field in which people have few options. There are other hospitals in Dallas, but they might not be as nearby or accept the right insurance or perform best at a given specialty. When people have few options, they tend to be more satisfied with the option they do have. Presbyterian’s Facebook boosters might be sticking by it simply because they don’t have anywhere else to go.

If there’s an upside to all of this, it’s that it’s highly unlikely that Presbyterian will repeat its mistake in the (also unlikely) event it sees another Ebola patient. People who trust their doctors are more likely to follow their recommendations. And in some cases, the doctor-patient bond is associated with better patient outcomes. So while publicly cheering Presbyterian hospital might not make much sense in light of recent events, it might be better for Dallasites in the long run.