Stifling Innovation

Low levels of trust can hurt innovation. We think of medical innovation as being driven by doctors, scientists and entrepreneurs, but patients play an important role, too. They must be willing to try new treatments and technologies for them to spread, but are unlikely to do so if they don’t trust in the therapy’s effectiveness or the prescriber’s motives.

One study found that for cancer patients considering experimental chemotherapy, trust in their physician was one of the most important reasons they enrolled in a clinical trial — on par with the belief that the treatment would be effective.

Today, in the era of wearable devices and electronic health records, trust that personal data will be kept secure and private — and that such technologies are useful — remains a barrier to greater acceptance and use. Despite millions of dollars being poured into telemedicine, Americans are still much less likely to trust diagnoses made remotely than those made in person.

Responding to Epidemics

Perhaps most concerning is evidence that low levels of trust can weaken the ability of governments and public health agencies to respond to epidemics. A recent study suggests that Ebola spread more widely and persisted longer than it otherwise would have if there were higher levels of institutional trust.

Researchers surveyed people in Liberia about their knowledge of Ebola, about how much they trusted the government, and how likely they were to take recommended precautions against Ebola. These precautions included adopting safe burial practices; abiding by restrictions on travel, social gatherings and curfews; keeping a bucket of chlorinated water at home; and avoiding physical contact with those displaying symptoms.

People who didn’t trust the government were much less likely to take recommended precautions. They weren’t less well informed about Ebola, nor did they hold more erroneous beliefs. They just trusted less.

Can Trust Be Rebuilt?

Trust, of course, requires trustworthiness. Waning trust in the health system is partly a result of the sometimes well-founded public perception that its key players pursue profits at the expense of patients. (The United States is the only wealthy advanced nation that has not committed to universal health care.)