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A Matter of Trust (Gaining the Trust of Patients and Society)

November 10, 2024

Hi everyone,

I cope with disappointment by reading. Obsessively. What’s done is done, but I seek to understand.

This was a bad year for incumbents, not just in the United States but everywhere, from left to right. If you’re unhappy with the world, vote the bums out.

Politicians are widely distrusted. In a January 2024 Gallup Poll, only 8% of respondents rated senators as honest and ethical. Congresspeople fared worse: 6%. Democrats rated senators and congresspeople slightly higher than Republicans (14% and 9% versus 4% and 2%), but the atrocious numbers send a clear message: Americans don’t trust politicians.

The poll also rated professionals from lawyers to teachers to bankers to veterinarians. Nurses topped the list: 78% of respondents rated them as honest and ethical. Doctors trailed at 56%, down 9% since 2019. Doctors scored worse with Republicans (48%) and those without college degrees (52%). Again the message is clear: trust in physicians is low and sinking. And if people don’t trust us, how can we expect patients to believe what we say, consent to procedures, or follow our recommendations?

Surprisingly little rigorous work has been done to define and measure trust, though most of us probably intuitively grasp what patients need from us: honest communication, competence, reliability, and compassion. Patients expect us to read, study, and learn from our mistakes. They expect us to keep promises, return phone calls, and prioritize their needs. And they expect us to acknowledge their fears, ease their suffering, speak gently, and pay attention. That’s how we earn trust.

We also need to gain society’s trust. In the coming months, we will be called upon to address contentious topics like vaccination, health insurance, climate change, worker safety, gun violence, drug prices, and reproductive rights. To advocate effectively, we need to educate ourselves, listen carefully, speak honestly and clearly, and acknowledge uncertainty where it exists, particularly as we combat misinformation.

While I’m no political consultant, I’m sure the same principles apply to politicians who hope to win our votes and to whom we entrust our freedom, safety, and our country’s future.

Enjoy your Sunday, everyone. I’m heading out to the bike trail.

Mark

What I’m reading: