January 8, 2019
Today the ABIM Foundation launches the Trust Practice Challenge, an effort to collect examples of practices that can promote trust across different health care settings and relationships. We are looking to learn about specific approaches that have shown promise in improving trust between clinicians and patients, among clinicians, between clinicians and health systems/hospitals, between patients and health systems/hospitals, and in other contexts. Our emphasis on specific practices dovetails with our plan to disseminate the practices we collect broadly, offering a practical guide for all those interested in building a more trustworthy health care system.
This challenge is a key component of the Foundation’s new focus on issues of trust in health care. We chose to emphasize trust because this crucial aspect of an effective health care system is currently under threat.
Promoting trust is an important component in our mission to advance medical professionalism to improve health care. It is central to many of the commitments outlined in the Physician Charter, such as maintaining trust by managing conflicts of interest, being honest with patients, and preserving patient confidentiality. Indeed, trust goes to the very heart of the patient-physician relationship, as patients rely upon their physicians to protect their health and even their lives.
However, there is evidence that Americans’ trust in the health care system is strained. While 73 percent of Americans said they had great confidence in the leaders of the medical profession in 1966, only 34 percent said so in 2012. Eighty percent of Americans expressed a “great deal” or “quite a lot” of confidence in the medical system in 1975; by 2015, that number was 37 percent. And although the U.S. ranked highly (3rd out of 29 nations) in the satisfaction patients expressed in the care they received when they last visited a physician, we only ranked 24th out of 29 in agreeing with the statement, “all things considered, doctors in the U.S. can be trusted.”
The ABIM Foundation hopes to work with multiple partners from all aspects of health care to help reverse these trends. The Trust Challenge, and the ideas we expect it will generate for the field, is one such initiative. We are also exploring strategies to combat misinformation in health care. We are exploring other potential paths to build trust as well, and I’ll use this space to keep you informed about our progress and new ideas.
In the meantime, please consider entering your own ideas into the challenge, and encouraging others to do the same.
Tim Lynch & Daniel Wolfson