Civic Trust in Medicine and Public Schools: Paradoxes Galore

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There is a scene in the film “Hannah and Her Sisters” where the character Mickey, a hypochrondriac played by Woody Allen, goes to his doctor to see if  his loss of hearing is due to a brain tumor. The doctor runs a series of tests and can find no evidence that Mickey has a tumor. The doctor says to Mickey: “trust me.”

The film came out in 1986. In the current political climate of contested health insurance, 20-minute visits with harried doctors who scan records on the computer screen, and Internet self-medicating, few doctors would say “trust me.”

Polls do show a decline in public confidence in medicine. The 2010 Harris poll on confidence in institutional leaders, 34 percent of respondents said they had great confidence in their medical leaders (down from 73 percent in 1966).

Of course, there has been a general decline in trust among Americans in the past forty years for nearly all institutional leaders except for the military. But confidence (I am using trust and confidence interchangeably) in national leaders is not the same as trust in one’s own doctor. A recent poll showed that 79 percent of people surveyed trusted their personal physician. The huge gap between confidence in national medical leaders and one’s own doctor is similar to what goes on in schools.

In the Gallup/Phi Delta Kappan  2010_Poll_Report, those surveyed were asked what grades (A, B, C,D, or F) they would give to the school that their oldest child attended. Seventy-eight percent of the respondents gave an A or B–the highest percentage ever given since pollster asked this question a quarter-century ago. For public schools nationally, however, 18 percent of the respondents gave an A or B –the lowest percent since 1985.

How to explain, on the one hand, the paradox of a large gap between public confidence in national medical leaders and trust in personal doctors and, on the other hand, the huge split between respondents on the quality of public schools nationally and the local schools that their children attended? Social scientists and historians have offered many explanations for the gradual loss of what some call “social trust ” (pp. 148-150). Some point to the U.S. Constitution fragmenting power among three branches of national government and establishing a federal system further splitting power thereby guaranteeing skepticism of government officials. Others point to recent demographic and socioeconomic changes in the population or to specific events like Watergate, Katrina, etc. Research mixed with speculation offers no sure-fire explanation for the loss of “social trust” in national institutions and the counter-point of vigorous “personal trust” for family physicians and local educators.

For schools, the gap between “social” and “personal” trust shows that media and unrelenting policy talk about all U.S. schools being “broken” has influenced public perceptions of schools. The constant media and policy elite drumbeat of “fixing” failing schools and the careless, even mindless, fusion of urban schools with all U.S. schools accounts, to a large degree, for the bleeding of “social trust” in public schooling. How many times must it be said that urban schools, in need of enormous help, are still not all U.S. schools?

That only 18 percent of respondents in the 2010 Gallup poll gave schools nationally an A or B should raise serious questions about the very legitimacy of tax-supported public schools. But when it comes to the local school, respondents’ personal knowledge trumped what they had heard about the nation’s “broken schools” from media, policy debates, and the Bush/Obama agendas for school reform.

How do I make sense out of these paradoxical responses?

In my judgment, poll results showing “personal trust” to be much higher than “social trust” in both medicine and schools are markers of the confidence that Americans have in their actual doctors and educators, not distant ones . Patients’ direct contact with doctors’ expertise, social skills, and concern for them form the interpersonal bonds that comprise that perosnal trust. Ditto for teachers and principals at the local school. Even amid the current geyser of national teacher-bashing and schools-are-broken rhetoric, much confidence in local schools–those interpersonal bond anchored in direct experience–appears in these polls.

The exception, of course, is in poverty-impacted urban districts where bonds of personal trust had frayed considerably. In the past quarter-century, vouchers, charter schools, and other choices have been expanded and parents who have been distrustful of their neighborhood schools now have choices. In these schools, parents have developed those interpersonal ties.

Today few educators and doctors say to their students and patients “trust me.” But if the polls are accurate gauges of public attitudes, as I believe they are, many parents and non-parents, at a time when it is politically suspect to respect educators, whisper to the professionals they know: “I trust you.”


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One response to “Civic Trust in Medicine and Public Schools: Paradoxes Galore

  1. Pingback: What Do Parents Want? | Engaging Parents In School...

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