Treating Patients Is a Matter of Trust

An article recently caught my attention regarding a poll that was commissioned by the Gallup organization and the Knight Foundation that focused on how Americans’ trust in the media has eroded.¹  

Where Walter Cronkite was once considered the “most trusted man in America,” many Americans (36% moderately, 48% greatly) believe that news outlets have contributed to the division among the population.¹ The COVID-19 pandemic and all its fallout have left many people confused as to how to manage their individual situation (vax/no vax or mask/no mask, for example) due to often conflicting views on how best to manage the virus. With many aspects to consider—whether physical, economic, social, psychological, or political—people have expressed their frustration with information that has been presented, and with much skepticism. Regardless of whose version you side with, a lack of trust in the opposing view of things tends to fuel further mistrust.

Merriam-Webster defines trust as “assured reliance on the character, ability, strength or truth of someone or something.” Let that sink in. A key point is that truth is essential for the existence of trust.  

Who do you trust? Do you trust yourself? Do you trust others? At some point in our lives, someone or something has betrayed our trust, and often that something or someone was once trusted. How do we move on when trust has been violated? How can we regain trust where it has been lost or how do we regain the trust of someone whose trust we may have betrayed? Sometimes the loss of trust can be a life lesson that can keep us from further emotional or physical harm. Not everyone or everything deserves to be trusted. That is on them, not you.

Why, then, is trust such an important concept? It is part of a moral compass and can be indicative as to how one perceives the world. Our legal system holds that people are innocent until proven guilty. Many societies take the opposite view, emphasizing that people are guilty until proven innocent. Personal philosophies can be crafted around this concept. I would tend to believe that those who see most people as innocent also see them as good and worth trusting. The other viewpoint is more pessimistic and those of this mindset would likely see others as always needing to demonstrate trustworthiness. I suspect those who hold this latter belief system to be among the least happy among us.

The cynics among us have likely been around long enough to recognize deception and “nonsense” when they see it. We as a society find ourselves in a time when trust in the information we receive must be scrutinized extensively due to conflicting information, “fake news,” rumors, and anecdotes that often stoke fear. Despite that, we are wired to and must trust others, despite the challenges.   

How has the erosion of trust impacted your medical practice?  

Has a lack of trust affected your medical decision making or how you communicate with your patients? Do you trust your hospital administrators, insurance company panels that you must seek pre-authorization from, the government and its ever-increasing control in determining the way you practice? Do electronic medical records make us more efficient, or are they an elaborate way of mining data that pits doctor against doctor? Have your patients expressed concerns or questioned your recommendations or management of their conditions due to the information they receive, otherwise known as “receiving their MD on Google”?  

These are some of the questions I have heard others ask or I have asked myself over the years, and with increasing frequency, it seems. One thing is certain: as trust erodes, frustration grows.

We need truth, facts, and the ability to trust each other. Trust is sometimes given freely; sometimes it is earned. No matter how it has been attained, trust must be protected through the integrity of words and actions. When trust is gone, there is a breakdown as to what can be achieved and accomplished.  

Dr. Desmond Bell is the Founder and President of “The Save A Leg, Save A Life” Foundation, a multidisciplinary non-profit organization dedicated to the reduction in lower extremity amputations and improving wound healing outcomes through education, evidence-based methodology and community outreach. He also serves as Chief Medical Officer of Omeza, an evidence-based medical technology company and consumer healthcare products company initially focused on healing chronic wounds and preventing their recurrence. In 2020, he joined MD Coaches as an Executive Physician Coach, serving as a peer to peer mentor.

Reference

1. Knight Foundation. American Views 2020: Trust, Media and Democracy.