Regarding the recent Guest Expert column “Increasing erosion of trust threatens relationships essential in practice of medicine,” the ABIM Foundation’s Daniel Wolfson gets it right in noting the impact of trust on patient/caregiver communication, compliance, outcomes and healthy behavior.
Although many general societal factors have an impact on trust, these are not easily fixed. The provider/patient dyad, however, is far more susceptible to management. We already have solid insights into the kinds of behaviors that can enhance trust, yet these are typically not stressed in professional training curricula or nurtured sufficiently in clinical settings.
They’re simple enough: Listening empathetically and recognizing that patients bring cultural, economic and emotional baggage in addition to their physical symptoms; taking time to answer questions; explaining what will happen next and why it’s the preferred option, when it will happen, what it will feel like, who will do it, how long it will take and what will follow. Not surprising, these are also keys to stellar patient satisfaction. If we cannot impact the broader societal sources of distrust, we should double down on factors within our control—caregiver training and clinical behavior.
Irwin Press, Ph.D.
Co-founder, Press Ganey
Rush University System for Health