The Cost of Distrust

What is the cost of losing trust?

Over the last few years, we’ve tracked the erosion of trust people say they have in healthcare in general and hospitals specifically. The post-pandemic decline is an echo of a societal loss of trust in institutions anywhere and everywhere.

Who cares, really? Maybe tracking a virtue is an ivory-tower exercise disconnected from real-world challenges.

But Helene and Milton have taught us a very different lesson; the great storms have provided us all a horrific case study in what can happen when trust is lost.

As we’ve witnessed (and some, sadly, have experienced), the loss of trust may come with the cost of life itself.

“Officials said this week that the disinformation about Hurricanes Helene and Milton was making relief workers a target, and the American Red Cross warned that the outlandish claims could prevent survivors from seeking help,” wrote the New York Times in “Bizarre Falsehoods About Hurricanes Helene and Milton Disrupt Recovery Efforts.”

Before Milton hit Florida, FEMA administrator Deanne Criswell warned mis- and disinformation are not only impacting the morale of first responders on the ground but deterring people from applying for critical aid that could provide crucial storm assistance, Axios reported.

The distrust "creates so much fear that my staff doesn't want to go out in the field, then we're not going to be in a position where we can help people," Criswell said.  

The broadscale, multiyear erosion of public trust in all institutions made the ground fertile for misinformation and rumor mongering about disaster readiness, aid, and, now, recovery. It’s a high cost that is plain to see.

If we’ve forgotten the education healthcare providers received during the season of mass COVID vaccinations, we’re offered here a painful remedial course.

The answers are right there on the chalkboard. It says: The line between trust and choice is direct and bold. This is especially so when the choice is existential and beyond the experience of most people, us included, dear reader.

To trust is to risk. In times of stress, when we cannot choose based on what we comfortably know, we choose to act – or not act – based on who or what we trust.  

Yes, healthcare is an eminently practical service. We measure our performance like nobody’s else’s business, from outcomes to RVUs to “how did you like the food while you were under sedation?”  

But it is also deeply emotional and personal. It’s people and the lives they live, not EHR records to be aggregated. So, trust – an emotional currency – is needed as much if not more than the metrics.

Underneath most everything we measure is a measure of trust. It’s the bedrock for everything a healthcare provider wants to build or protect.

Any healthcare organization that is deeply trusted – by its associates, by its patients and community – can move into the future faster, make bolder bets and fulfill its mission with greater confidence. This is all especially so when the stakes are high and the consequences meaningful.

The potential of trusted organizations is greater because stakeholders’ willingness to risk is higher.

For organizations that carry little trust? The willingness of important audiences to take risks is tentative, each step forward needs to be explained and argued and proven. For even the most well-constructed argument or best engineered plan, lack of trust is sand in the gears.

To be clear: Trust in healthcare providers remains relatively high compared to most other institutions. Congress wishes it lived in our reputational neighborhood. Providers are powerfully positioned and uniquely resourced to address the challenges of trust in their communities.

But providers no longer serve in a vacuum, if we ever did.

There are other voices actively at play in our industry (and, maybe, in your market) who do not share your goals or interests. Some offer competing versions of how healthcare should be funded and delivered. Other push pointed critiques of hospital finances and community benefit. Others are happy to share misinformation and disinformation about health itself, pitting clinicians in bizarre health-knowledge arenas with their own patients who – like some struggling with the effects of the hurricanes – choose not to see vital help.

Helene and Milton are teaching us again though a terrible lesson that trust is valuable, precious and fragile. Intentional acknowledgement and action is required to protect it. An umbrella for the rain.

Healthcare providers must not wait on a storm – real or metaphorical -- to learn this lesson again.