A clinician holding the hand of a patient.

Drawing on previous collaborative efforts to address low-value care, AcademyHealth and the ABIM Foundation have announced a new effort focusing on rebuilding trust in health care. This partnership is part of the ABIM Foundation’s Building Trust initiative, and aims to advance research about what creates or inhibits trust among physicians, patients, organizations, and other health care stakeholders.

As part of this work, AcademyHealth will undertake a number of activities aimed at:

  • understanding the current landscape of research about trust and available funding for future projects;
  • creating the case for the importance of trustworthiness in health care organizations – both with historically marginalized populations and in science and evidence; and
  • building a community of researchers and health care leaders that desire to advance the evidence on what creates trustworthiness and its effect on health outcomes.

“As our health care system confronts new and ongoing threats to the nation’s health and well-being, the importance of addressing the issue of trust has never been more vital,” said Dr. Lisa Simpson, president and CEO of AcademyHealth. “A basic aspect of any relationship, trust is central to engendering meaningful health care interactions. Ensuring that patients and communities, particularly those who continue to experience health disparities, can be confident in and trust their interactions with clinicians and the broader health care system is crucial for effective care delivery and ultimately improving health outcomes.”

A recent JAMA Network editorial noted that trust in the U.S. health care system has declined significantly in the last 50 years. Between 1966 and 2012, confidence in medical leaders decreased by 39 percent, while a 2017 survey revealed that only 18 percent of respondents expressed a high level of confidence in the U.S. health system. In addition, a 2021 study commissioned by the ABIM Foundation found that 32 percent of people reported that their trust in the system decreased during the COVID-19 pandemic.

“Lack of trust in health care is well-documented, but approaches for how to build back trust are much less discussed and not very well understood,” said Daniel Wolfson, MHSA, executive vice president and chief operating officer of the ABIM Foundation. “Working with stakeholders from across the system to conduct research and find approaches to increase trust among patients, clinicians and system leaders puts us one step closer to achieving greater health equity and better health outcomes for all.”

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   As an additional observation, I would strongly recommend a report published by the BMJ in 2016. It is probably the best effort to demonstrate the "reverse causality" connection between HEALTH and TRUST. Located at the Lund University in Malmo Sweden, the report's authors and their colleagues have published multiple reports about health and trust since 2009. A Google Scholar search for the two author combination would be well worth the effort. Giordano, GN  &  Linstrom M. Trust and Health: Testing the reverse causality hypothesis. J Epidemiol Community Health 2016;70:10-16.

Submitted by Paul J Nelson on Friday, July 30th, 2021 at 14:54 pm

...Any discussion about trust will eventually encounter a wide variety of Social Interaction related concepts, especially Social Dilemmas, Social Capital, Social Mobility, Social Cohesion, and micro- / meso- / macro-social networks.  Encountering this horizon of knowledge can incite a bewildering level of cognitive dissonance.  As a result, I would direct everyone to 18 research reports authored separately or in combination by Giuseppe Nicola Giordano and Martin Linstrom since 2009 (both members of the Faculty of Medicine, Lund University located in Malmo, Sweden). ...By my own assessment, the most thoughtful of these studies was published in 2016: "Trust and Health: testing the reverse causality". See ( http://dx.doi.org/10.1136/jech-2015-205822 ).    

Submitted by Paul J Nelson MD on Wednesday, August 4th, 2021 at 12:17 pm