During my years as an academic Hospitalist and now as a volunteer educator, I have taught medical students and residents that trust is the most important aspect of the doctor-patient relationship. While patients understand that medicine is an inexact science, that mistakes may occur and that successful results are not guaranteed, they need to know that their provider will do whatever he/she can to diagnose and treat their condition and will keep them informed regarding what they discover and what they don't yet know. Their trust is earned by such an approach and the willingness of their provider to consult specialists, when appropriate, augments their level of comfort.
Unfortunately, the member nations of the World Health Organization have not engendered the trust of the international community in their approach to the ebola epidemic in West Africa; resources were initially inadequate and the disease will now be much more difficult to contain. In a similar vein, the CDC, while attempting to calm the American public, offered reassurances that they were in no position to meet; containment of ebola in Texas has been hampered by a number of missteps, including inadequate resources and a lack of strict attention to the enforcement of protocol and quarantine measures.
As a result, the CDC must now re-earn the trust of the American public. Of more concern, they have lost control of the message which is now in the hands of cable news programs and the social media; as one might expect, hyperbole, inappropriate comparisons and inflammatory statements have entered the public discourse and, as a result, anxiety has become systemic. The management of a public health emergency requires careful planning, public education, honest discussion and aggressive intervention; until those factors come together, public trust and cooperation will be lacking and the control of ebola in America will be hampered.
