I am currently reading The Trust Prescription for Healthcare. In this book, David Shore, an associate dean at the Harvard School of Public Health, outlines the importance of trust for the healthcare consumer. He discusses how the concept of trust is important not only in the physician-patient relationship, but also in the relationships held between patients and healthcare organizations.
I like the first sentence of Shore's book: "Trust is the currency of all commerce." It is.
There are many studies that show that consumers are more likely to do business with companies that they trust. And you need only to read any one of Thomas Friedman's books to see how a lack of trust (often brought on by corruption) has kept many countries from realizing their commercial potential.
But the relationship between trust and healthcare is unique. As a patient, trust is vitally important because we are extremely vulnerable when we engage with the players in the healthcare system. We rely on the intelligence, training and good judgment of others to provide advice, keep us healthy, and get us better when we become ill or require treatment.
In that regard, we often have vivid memories of the times where trust has been violated. I can think of two examples in particular from my life where trust in a clinician was compromised.
The first example revolved around my childhood dentist. He was a big guy, probably in his early 50s. He had a good demeanor and always asked me about school and sports. But he had horrible teeth and bad breath. I was only about ten years old at the time, but still savvy enough to think to myself "should I really listen to a guy about dental care if he doesn't seem to practice good oral hygiene himself?"
The second example revolves around a General Practitioner of mine. During my annual physical, I was going over a list of questions I had written down about my general health - should I worry about this mole? What about my family's history of heart disease?, etc. After each question he gave what I considered an intelligent, reasoned response.
After one question, though, his reaction was very different. He said to me in an extremely condescending tone "Why are you asking me that? I'm not the person to talk to about that - you would need a specialist for that." I won't divulge what my question was (for fear of committing my own, personal HIPAA violation), but he certainly should have addressed my question, and in a much more patient-friendly tone.
Back to the concept of trust and commerce. As a ten year old boy, I had little influence on what dentist our family went to. But as an adult living in one of the most respected healthcare environments in the world, I certainly had the power to reduce the ranks of this guy's practice. Not only did I find a new doctor, but a friend of mine stopped seeing him based at least in part on hearing my story.
I would give David Shore's book a try. The public's trust in medicine has decreased tremendously in the last forty years and this has a wide-ranging implications for those of us that work in, or for, healthcare-related organizations.
And while the idea that trust as a crucial element of healthcare is not novel, I think the power of this book relies on the depth of knowledge that Shore brings to this topic as well as the real world examples he provides. And I am sure that, like me, soon after you begin reading this book you will begin to revisit those positive and negative experiences you have had in dealing with the healthcare system.
