Solving the Crisis of Patient Distrust

The Problem

Patient trust is the foundation of positive patient-provider relationships and fundamental for effective treatment. Trust impacts everything from treatment adherence to health outcomes and behaviors to the likelihood of a patient returning to a provider.

Unfortunately, patient distrust in the healthcare system has been growing over the last half century and has, undoubtedly, been exacerbated by the COVID-19 pandemic. And while patient distrust of their providers has not declined to the degree to which distrust in the system itself has, it has certainly taken a hit in recent years. 

In fact, in a recent survey on patient trust, more than a third of participants said they skipped or avoided care because they did not like the way the healthcare provider or staff treated them. And nearly 80% of the participants said they would not return to the same provider if they had an experience where they lost trust (Read et al., 2021).

But why have we seen this decline in trust? And what can we do about it?

The Reasons

There are countless theories surrounding why patients distrust their providers, but some of the more commonly cited reasons include:

• Experiences during which patients felt their providers discounted their symptoms, did not listen to them, were culturally insensitive, provided incorrect information, and did not engage with or care for them (Read et al., 2021). Contributing to this is often limited time allowed for patient-provider communication and the fragmentation of the patient-provider relationship.
• A lack of culturally competency.  Trust in healthcare is even lower among patients of color and other historically marginalized and minority patients. Cultural and linguistic differences can make building trust challenging; and differences in beliefs, values, expectation, and style of expression or behavior can all contribute to distrust.
• Increased access to information. We, as a society, have experienced rapid growth of competing and contradictory information when it comes to both personal and public health. Distrust can arise when this information does not match up with what providers believe or communicate to their patients.
• The imperfections of the industry or institution. These imperfections have become clearer to patients over the years, particularly with the rise of managed care and related financial incentives, conflicts of interest highlighted by the media, and growing perceptions among patients that healthcare operates like any other business.
• Insurance. When a patient faces financial challenges due to insurance coverage, it often hurts their relationship with their provider, regardless of the provider’s culpability. And at a more macro level, healthcare insurance coverage has become a controversial issue on the national stage, and beliefs about the issue can roll into the patient-provider relationship

• Don’t challenge core beliefs or overwhelm patients with information. This is particularly true in the midst of the COVID-19 pandemic, where providers may be increasingly faced with patient beliefs that contradict their own.