Busted trust

Only nine percent of U.S. consumers believe pharmaceutical and biotechnology companies put patients over profits, while only 16 percent believe health insurance companies do, according to a Harris Poll study released today. Meanwhile, 36 percent of U.S. adults believe health care providers (such as doctors and nurses) put patients over profits, compared to hospitals (23%).

That was before the pandemic. Now, trust is as rare as an N-95 mask for nurses and nerves are raw.

Indeed, this report notes, “The public trusts healthcare workers. In April 2020, 89 percent of adults had a favorable opinion of both doctors and nurses. Today, that number still hovers around 85 percent. Despite this healthcare heroism, the public has only lackluster approval of hospitals based on their business practices.?

As one doctor editorialist noted, "We are at a crossroads in medicine when it comes to public trust. After a pandemic that twisted science for political gain, it is not surprising that confidence in medicine is eroding. In fact, trust in medical scientists has fallen to its lowest levels since January 2019."

Trust is in short supply around the world and across industries and organizations. For 17 years the?Edelman Trust Barometer?has surveyed tens of thousands of people across dozens of countries about their level of trust in business, media, government, and NGOs. This year was the first time the study found a decline in trust across all four of these institutions. In almost two-thirds of the 28 countries we surveyed, the general population did?not trust the four institutions to “do what is right”?— the average level of trust in all four institutions combined was?below 50%.

The?2020 Edelman Trust Barometer - now in its 20th year - has found many people no longer believe working hard will give them a better life.

A 2022 Gallup poll found that the average level of confidence in a broad range of institutions like the military, the Supreme Court and big business was only 27 percent.

Levels of trust in this country—in our institutions, in our politics, and in one another—are in precipitous decline. And when social trust collapses, nations fail. Can we get it back before it’s too late?

AI could break democracy.

Busted trust is growing in medicine too.

1. Patients don't trust their doctors
2. Doctors don't trust their patients.
3. Many don't trust politicians or regulators to protect their interests
4. Doctors don't trust practice guidelines and evidence based evidence reports.
5. Communities don't engage because they don't trust each other
6. Teams don't work because members don't trust each other

1. Patients don't trust telemedicine
2. Doctors and administrators don't trust each other
3. No one trusts insurance companies and payers
4. Doctors don't trust other doctors
5. BIG PHARMA has lost the trust of the public.
6. Pervasive misinformation on the internet and social media
7. Medical expertise is dead
8. Patients don't trust AI Here are 12 reasons why.
9. Medical professionals don't trust public health and national leaders. Now, there’s simmering anger, and a deep sense of betrayal among health professionals who say they feel forsaken by their government.
10. Citizens can't trust each other to follow stay at home and other public health guidelines
11. Team members don't trust each other working from home.
12. Potential customers don't trust salespeople whom they never get to meet face to face.

Why is it so hard to do the right thing and earn someone's trust?

1. People are inherently flawed, "broken branches" and turn a blind eye to their foibles

2. The world is getting more complicated with intertwined conflicts of interest that often fall in the grey zone

3. Society has become more permissive

4. People think they can get away with it. They are often right, particularly when you have power, influence or money.

5. Rules of civility have become more lax

6. A possible decline in self-disciplinary skills and delayed gratification. More and more people choosing the one marshmellow over two later on.

7. A media and communications culture that showcases the Big Me over the Little Me.

8. Pressure from investors and shareholders at the expense of patients because the stakes are getting bigger.

9. A culture of entrepreneurship that fosters an ethos of a win at all costs.

10. The differences between the ethics of business and the ethics of medicine.

Leadership is about earning the trust of followers.

Doctors don't trust their employers. Here are 10 reasons why.

So, how do you build trust? Jet Blue chairman Joel Peterson offers 10 steps on how to establish and maintain a culture of trust.

Since 1979 Gallup has measured trust among the public in the most important American institutions—from the presidency and the Supreme Court to big business, science and the media. Its latest survey, published in July, found that across the nine key institutions Gallup has tracked consistently, the proportion of Americans who said they had “a great deal or quite a lot of confidence” averaged out at 26%. That is the lowest figure ever recorded.

Maybe the only thing you can trust is your instincts and that should keep you on the straight and narrow. Trust me.

Arlen Meyers, MD, MBA is the President and CEO of the Society of Physician Entrepreneurs on Substack and Editor of Digital Health Entrepreneurship