Periodically, there are discussions regarding the critical component of trust in healthcare. Currently, the present pandemic is a prime example of the issue. Some, we observe, inherently trust science; others prefer the approach, I need to distrust you until you prove to me you are trustworthy. A third category proclaims I trust you; however, I must verify the proclamations myself. An individual’s human nature dictates which of these categories best fit.
For those in the latter two domains, where we need to earn their trust or to verify that we are trustworthy, it is important we demonstrate empathy, honesty, and open and engaging communication. Unfortunately, recently, healthcare has fallen in these areas. Moreover, compassion requires time, listening, and active participation in understanding and solving a patients’ utmost concerns, and not necessarily what we as practitioners might believe is of greatest importance. The focus on pricing and quality transparency have the unintended consequence of breeding the idea that healthcare is dishonest. Meaning, if the industry is honest, why do we need rules around these items?
Furthermore, it’s crucial to recognize that our “consumers” are facing a situation through their own individual reality. In essence, healthcare has become more expensive and for many unaffordable, the practice of medicine has become more complex as treatment modalities have increased, and avoidance of challenging conversations continues to occur.
If we are to build trust, it’s vital to realize that we must first identify and acknowledge the considerations of the “demand” side, which represents those we serve. Without recognizing their needs, we, the “supply” side, will not solve these issues unless we first understand the fundamental concerns they have.
With regards to cost, we must first realize the affordability is the primary concern that worries people. As clinicians, we frequently believe this is not our issue since our role is to diagnose and treat. However, suppose that we create a dynamic that is not front and center to a patient by ignoring their needs. In that case, our treatment success will be diminished, thereby creating an additional problem, worsening of financial health. As clinicians, we must focus on all three variables that drive value: quality, service, and cost.
Affordability is just one piece of the trust puzzle. Guiding conversations that are much more transparent and bi-directional have a significant impact on trust as well. Though we might not have all the answers or even positive news, simply having these conversations is a component that builds trust, not the information we share. We must become more attuned to the dynamics of behavioral sciences. Furthermore, we focus on physiologic science to such an extent that we forget the importance of the dynamic between the two.
An additional area requiring focus is that of managing expectations. Merely discussing the possible side effects of treatment does not address a consumer’s needs. They wish to know what to expect regarding treatment, the likelihood of success, and what they will give up to obtain the results.
As trust is paramount to our success, we must remember all the dynamics in play. We will not succeed overnight, but we must show improvement if we genuinely desire to impact the lives of those that have entrusted us with their care.