Here is a figure that will surprise those who hear seemingly endless gripes about doctors and assume most of us must dislike our physicians.
Three out of four persons say they have a regular doctor or doctors. And 95 percent of them say they are "satisfied" with their doctors.
Their opinions are not based on past history. Eight persons in 10 say they have seen a doctor in the last year.
Those figures come from a recent Washington Post-ABC News poll, based on telephone interviews in October with 1,056 adults selected at random in 48 states.
The result is not very different from most of those in other recent surveys. A Louis Harris poll last year found that at least 95 percent of persons with a personal doctor give him or her a favorable rating on competence, caring, communicating and spending enough time, and almost as many rate their own doctor highly on friendly personality, health advice and reasonable fees.
A Robert Wood Johnson Foundation study last year found that 78 percent of those who had seen a doctor were "completely satisfied."
Still, these figures don't tell the whole story. Most of us, it seems, like some doctors, dislike some others and may have different feelings altogether about medicine generally. When pollsters ask, "What do you think of doctors in general?" the answers get more unfavorable.
"MDs' Public Image Going Down," said a headline last June in the American Medical Association's American Medical News, a publication that is, to the AMA's credit, a remarkably candid weekly for doctors' reading.
The AMA has a survey done every year by an independent research group. In 1984 only 27 percent of the public called doctors' fees in general "reasonable," down from 42 percent in 1982. Sixty-two percent said doctors took a genuine interest in their patients, compared with 68 percent in 1982. Forty-four percent said doctors usually explained things well, compared with 55 percent in 1982.
The survey was repeated this year, with results generally more favorable to doctors by four to six percentage points, though still not up to the 1982 numbers. Sixty-four percent of those questioned said people are losing faith in physicians, though here as in other polls people were usually complimentary about their own doctor.
Perhaps our "own doctor" is the one we settle on after considering or rejecting others. Perhaps we've come to know his or her good points and decided they outweigh any bad ones. Or perhaps -- as long as we are reasonably satisfied -- having faith in our doctor is an essential part of having faith in our own fitness to face the world and ourselves.
For many of us, "our doctor" is indeed one we've found after dissatisfaction with one or more others. This was one fact confirmed recently by Norman Cousins, the longtime editor turned friendly critic of medicine and medical faculty member at the University of California at Los Angeles.
In the Nov. 28 New England Journal of Medicine, Cousins tells of brooding over the fact that many medical students "seemed reluctant" to give much importance to communication, medical ethics or "the circumstances of a patient's life," compared with their understandable preoccupation with the difficulties of anatomy, physiology, disease and diagnosis.
So Cousins -- seeking "rough clues" at least to patients' attitudes about their doctors -- distributed 1,000 questionnaires in Los Angeles' Westwood area, as what he called an in-no-way scientific survey in an upscale neighborhood. He reports getting 563 responses, "unusually high" considering that the questions demanded written answers and the respondents had to address their own envelopes and add postage.
"The most striking fact," he found, "was that 85 percent . . . had either changed physicians in the past five years or were thinking of changing for reasons other than relocation, the physician's retirement or death."
Only 25 percent of those who had changed doctors blamed incompetence. "Why, then, did they change?" Mostly because of a doctor's "style or personality," including poor communication, a disorganized or cluttered office, inability to inspire hope or confidence and jarring personal habits like smoking, obesity or lack of cleanliness.
Some patients' comments:
*"I had the impression that my doctor was not really listening to me. He could hardly wait to get me into the medical technology."
*"I didn't really understand what the doctor was saying and was too embarrassed to ask."
*"The physician apparently forgot that he had already discontinued the medication he was now prescribing [when] I had already had a very bad reaction to the medication."
*"I had a respiratory problem and thought it was bizarre that my doctor should be smoking while he discussed my case."
*"I was kept waiting more than an hour and, after I finally was brought into his office, my doctor took two personal telephone calls that ate up another 20 minutes of my time."
*"The physician didn't inquire into my eating habits and he didn't appear to regard nutrition as a relevant fact in my health."
*"The physician's bills seemed out of all proportion to the value of the services rendered or the time spent with me."
*"Paid too much attention to pain-killing medication and not enough to underlying causes."
*"I couldn't reach the physician by telephone when I really needed him, nor did he return my call."
But among those who had changed doctors, the overwhelming majority of Cousins' respondents said they were now satisfied.
Among the patients' suggestions: "Medical schools should help doctors in the art of communication." "Doctors should try to use technology as a backup and not as the primary factor of the examination . . . They need increased respect for the importance of a direct exchange with the patient." "Medical students should be taught how to deal with families . . . and not just with patients."
"The question" for medical students and educators, Cousins concludes, is not whether less import should be attached to medical science but whether enough is being attached to everything else it takes to give good care.