Patient Trust in Healthcare: 84% Trust Doctors, 33% Health Insurance Companies

This video provides an in-depth exploration of patient and doctor trust within the healthcare system, drawing insights from a January 2021 survey conducted by the American Board of Internal Medicine (ABIM). Dr. Eric Bricker, the presenter, uses the survey data to highlight significant disparities in trust levels across various healthcare entities, including nurses, doctors, government, pharmaceutical companies, health insurance companies, and hospitals. The core purpose of the video is to argue that understanding these trust dynamics is fundamental for driving any meaningful change in healthcare, as trust (ethos) is the prerequisite for persuasion and action.

The presentation details patient trust levels, revealing that nurses and doctors command the highest levels of confidence, with 85% and 84% trust respectively. Hospitals also receive a relatively high trust rating from patients at 72%. However, trust significantly diminishes when it comes to the government (56%), pharmaceutical companies (34%), and health insurance companies (33%). This stark contrast underscores a foundational challenge for sectors like pharmaceuticals and health insurance in engaging with the patient population.

Dr. Bricker then shifts to doctor trust, presenting even more striking figures. While doctors overwhelmingly trust other doctors (94% within their practice, 85% outside), their trust in hospital executives is surprisingly low at 53%. More critically for the pharmaceutical industry, only 47% of doctors trust pharmaceutical companies, a figure lower than the general public's trust in the government regarding health matters. Trust in health insurance companies plummets to an abysmal 19% among doctors. Dr. Bricker emphasizes that according to the ancient Greek model of persuasion (ethos, pathos, logos), credibility and trust (ethos) must be established first, followed by empathy (pathos), before logic (logos) can be effectively applied. Without this foundational trust, efforts to drive change or influence behavior are largely futile.

The video concludes by asserting that entities with low trust, such as health insurance companies, cannot realistically be the drivers of patient or doctor behavior change. Instead, any successful initiative for change must originate from or be channeled through highly trusted sources, primarily nurses and doctors for patients, and other doctors for physicians. This perspective offers a critical lens through which to view strategies for commercial operations, patient engagement, and professional education within the pharmaceutical and life sciences sectors, highlighting the imperative of building or leveraging existing trust.

Key Takeaways:

• High Trust in Healthcare Professionals: Patients exhibit very high levels of trust in nurses (85%) and doctors (84%), positioning these professionals as the most credible sources within the healthcare ecosystem.
• Low Patient Trust in Key Industry Players: Patient trust in pharmaceutical companies (34%) and health insurance companies (33%) is remarkably low, indicating a significant hurdle for these sectors in direct patient engagement and communication.
• Doctor Trust Dynamics: Doctors place extremely high trust in their peers (94% for those in their practice, 85% for those outside), suggesting that peer influence is a powerful mechanism for driving change among physicians.
• Pharmaceutical Industry's Trust Deficit with Doctors: Only 47% of doctors trust pharmaceutical companies, a critical insight for pharma firms aiming to influence prescribing behavior or introduce new therapies. This low trust necessitates indirect or highly credible communication strategies.
• Extremely Low Doctor Trust in Insurers: Doctors' trust in health insurance companies is exceptionally low at 19%, making insurers highly ineffective as agents of change for physician behavior.
• Foundational Role of Trust in Persuasion: Drawing on the ancient Greek model of ethos, pathos, and logos, the video underscores that trust (ethos) is the absolute prerequisite for effective persuasion and driving any form of behavior change.
• Implications for Driving Healthcare Change: Entities with low trust, such as health insurance companies, are unlikely to be successful drivers of patient or doctor behavior change. Efforts to change behavior must leverage or build upon existing trusted relationships.
• Strategic Communication for Pharma: Given the low trust in pharmaceutical companies by both patients and doctors, strategies for commercial operations, medical affairs, and patient education must prioritize building credibility or working through highly trusted intermediaries like physicians and nurses.
• Leveraging Trusted Channels: To influence patient behavior, engaging through nurses and doctors is paramount. To influence doctor behavior, peer-to-peer communication and endorsement from other trusted physicians are likely the most effective approaches.
• Challenge for Hospital Executives: The low trust of doctors in hospital executives (53%) indicates potential internal friction and challenges in implementing top-down initiatives within hospital systems.
• Data-Driven Understanding of Ecosystem: The survey data provides a concrete, quantitative understanding of the trust landscape, which is essential for any organization operating in or supporting the pharmaceutical and life sciences industries to design effective solutions and strategies.

Tools/Resources Mentioned:

• ABIM Foundation/NORC Survey: The video references a survey conducted by the American Board of Internal Medicine (ABIM) in January 2021, with data sourced from NORC (National Opinion Research Center at the University of Chicago). The specific source PDF link is provided in the video description: https://www.norc.org/PDFs/ABIM%20Foundation/20210520_NORC_ABIM_Foundation_Trust%20in%20Healthcare_Part%201.pdf

Key Concepts:

• Ethos, Pathos, Logos: An ancient Greek model of persuasion.
  • Ethos: Refers to the speaker's credibility or trustworthiness. The video emphasizes this as the foundational element for persuasion.
  • Pathos: Relates to appealing to the audience's emotions or empathy.
  • Logos: Involves using logic and reason to persuade. The video highlights that logic is only effective after ethos and pathos have been established.