Care Redesign
Clip
Earning Patients’ Trust: Back to Kindergarten (04:48)

Health care needs to work on the dual imperative of earning patients’ trust and being trustworthy. How can individual clinicians and health care organizations achieve that?

Historical and contextual factors will weigh into trust between patients and clinicians and between patients and the health system, says Russell Rothman, Professor of Internal Medicine and Vice President for Population Health Research at Vanderbilt University Medical Center. But one way to build better trusting relationships with patients and the community is to train individuals and systems in how to better communicate with patients, families, and the community — especially when it comes to listening.

We need to be better listeners “and do a better job of understanding the needs of our communities, and helping them to set shared goals,” says Rothman, “instead of the traditional, hierarchical model where we came in as the clinician and said, ‘Do this, do this, do this. Okay, you good? Great,’ and then we’d send them on their way.”

One of the keys to trust and being trustworthy is mutual respect, adds Consuelo Wilkins, Executive Director for the Meharry-Vanderbilt Alliance. “From the standpoint of many health systems, especially some of the really large academic medical centers, the level of prestige and the power imbalance is so huge that we often forget about the importance of valuing the other resources and the opinions and the needs, and we just think we have all the answers.”

How do you show that respect? By demonstrating that you value people. Instead of putting the blame on others — “they don’t trust us; they haven’t trusted us in years” — we need to take the blame ourselves as not being trustworthy enough.

Another key to being trustworthy is transparency, especially for health organizations entering into partnerships with the community. Far too often, health organizations don’t share the budget or will invite the community organization to join a grant and then not follow up with them, Wilkins explains.

“This is just about relationships, says Wilkins. “If you want to have a relationship with anyone, you have to respect them, you have to be respectful, you have to be transparent and not hide things. It’s just back to kindergarten.”

From the NEJM Catalyst event Expanding the Bounds of Care Delivery: Integrating Mental, Social, and Physical Health, held at Vanderbilt University Medical Center, January 25, 2018.

More From Care Redesign
Summary of Comprehensive Approach to Physician Behavior and Practice Change

Engaging Stakeholders to Produce Sustainable Change in Surgical Practice

How an initiative designed to improve patient outcomes and satisfaction while containing costs led to sustainable change in surgical practice and physician behavior.

Myths and Realities of Opioid Use Disorder Treatment.

Primary Care and the Opioid-Overdose Crisis — Buprenorphine Myths and Realities

There is a realistic, scalable solution for reaching the millions of Americans with opioid use disorder: mobilizing the primary care physician (PCP) workforce to offer office-based addiction treatment with buprenorphine, as other countries have done.

Coffey02_pullquote family-centered care in medical and surgical procedures

What If Family-Centered Care Were Extended to Medical and Surgical Procedures?

Though the concerns are valid, early experiences suggest that family member engagement may be an effective tool for improving the value of care.

Evidence Needed for Health Systems Change to Address Social Determinants of Health and Obesity and Diet-Related Diseases in Turn

Better Clinical Care for Obesity and Diet-Related Diseases Requires a Focus on Social Determinants of Health

To more effectively treat the problems of obesity and diet-related conditions, health systems need to restructure the traditional medical model of care delivery to address the social determinants of health.

People Living with Dementia Around the World - Value-Based Chronic Illness and Dementia Care

Value-Based Care Must Strengthen Focus on Chronic Illnesses

To effectively control costs and improve value, new models must address our increasingly older patients and chronic care patients, especially those with Alzheimer’s and related dementias.

The Barriers to Excellent Care Vary Widely Across Geographic Regions - both Rural Health Care and Urban Health Care

Survey Snapshot: Rural Health Innovations Born from Challenges

According to NEJM Catalyst Insights Council members, every health system has to develop its own definition of what is meant by “rural” health.

Same-Day Breast Biopsy Workflow at Baylor College of Medicine

How Care Redesign and Process Improvement Can Reduce Patient Fear

Seeing how clinicians take care of their own when they are in frightening situations was the epiphany that led to a same-day breast biopsy program.

Rural Health Care Is Rated Comparable or Worse Across Quadruple Aim Aspects

Care Redesign Survey: Lessons Learned from and for Rural Health

Although care delivery models in rural and urban/suburban areas are distinct, by virtue of geographic density and resource availability, each locale affords lessons for the other.

Comprehensive Intervention Review at Lurie Childrens Hospital - improving patient flow and length of stay

Reducing Length of Stay in the ED

A comprehensive redesign of triage and ED care.

Pumonary Nurse Post-Discharge Follow-Up Note for Patients with COPD

TOPS: Telephonic Outreach in the Pulmonary Service at VA Boston Healthcare System

A nurse-directed intervention targeting veterans who had been hospitalized for COPD resulted in improved access to ambulatory care and a reduced rate of readmissions.

Connect

A weekly email newsletter featuring the latest actionable ideas and practical innovations from NEJM Catalyst.

Learn More »

Topics

Social Needs

88 Articles

Better Clinical Care for Obesity and…

To more effectively treat the problems of obesity and diet-related conditions, health systems need to…

A Successful Pilot to Improve Access…

Actionable data and modest financial incentives can help motivate clinicians to adjust their behavior around…

Coordinated Care

129 Articles

The Evolution of Primary Care: Embracing…

Primary care must leverage disruptive innovations to ensure that patients receive first-access, comprehensive, coordinated, continuous…

Insights Council

Have a voice. Join other health care leaders effecting change, shaping tomorrow.

Apply Now