December 15, 2020
JAMA published an editorial and six articles this week about trust and health care—the centerpiece of the ABIM Foundation’s work to improve American health care. Each article developed ideas that arose in workgroup discussions at the 2019 ABIM Foundation Forum, which focused on developing strategies and practices to build trustworthiness at all levels of the health care system.
The authors address a variety of topics, from combating medical misinformation to the importance of trustworthiness among organizational leaders in health care. The breadth of these viewpoints illustrates the broad importance of trusting relationships across health care.
The articles are:
- Patient Consumerism, Healing Relationships, and Rebuilding Trust in Health Care (Dhruv Khullar, MD, MPP; Gwen Darien, BA; and Debra L. Ness, MS): This article surveys the health care system as a whole, describing barriers to building trust and offering recommendations for a path forward. The authors describe how building trust is essential for reducing health disparities and promoting health and well-being for all patient populations.
- Addressing Medical Misinformation in the Patient-Clinician Relationship (by Vineet M. Arora, MD, MAPP; Sonia Madison, MS; and Lisa Simpson, MD, MPH): This article describes why health misinformation spreads, discusses different varieties of misinformation, and offers solutions to combat it. It offers important advice about a phenomenon that threatens to undermine trust between patients and their clinicians in a health environment that can feel flooded by inaccurate information.
- Transparency as a Trust-Building Practice in Physician Relationships with Patients (Tara Montgomery, BA; Jeffrey S. Berns, MD; and Clarence H. Braddock III, MD, MPH): The authors suggest ways that physicians can employ transparency to build trust with their patients, such as by disclosing potential conflicts of interest and providing information about their clinical experience and performance. They argue that this level of transparency will help physicians earn their patients’ trust in a time of great uncertainty.
- The Enduring Importance of Trust in the Leadership of Health Care Organizations (Sachin H. Jain, MD, MBA; Catherine Lucey, MD; and Francis J. Crosson, MD): The authors describe types of leadership failures and propose a set of behaviors that can maintain trust between the leaders of health care organizations and those who work in and with them. This is an increasingly important topic in an era of increased consolidation in the health care sector.
- Human-Centered Design and Trust in Medicine (Alyse Wheelock, MD; Christine Bechtel, MA; and Bruce Leff, MD): The authors focus on how human-centered design—a ‘person-centered’ approach to restructuring systems—could improve health care delivery and foster trust in health settings, especially when used to design solutions based on both patient and clinician needs and experiences. By co-creating solutions with patients, we can better understand and address the challenge of low interpersonal trust.
- Rebuilding Trust and Relationships in Medical Centers (Reshma Gupta, MD, MSHPM; Leah Binder, MA, MGA; and Christopher Moriates, MD): The article addresses the relationship between patient trust in medical centers and the affordability of their health care. It reviews how medical centers could rebuild affordability-related trust and relationships with patients.