The Trust Crisis in Healthcare

Causes, Consequences, and Cures

Edited by David A. Shore

Editor David Shore is the founding director of the Harvard School of Public Health's Trust Initiative

The Trust Crisis in Healthcare

Causes, Consequences, and Cures

Edited by David A. Shore

Description

The lack of trust in our healthcare system brings ominous results, from decreasing health outcomes to increasing costs, from organisation inefficiencies to a pervasive pattern of litigation. This will only worsen as healthcare becomes subject to greater market mechanisms, and as patients, providers, and payers view each other with increasing suspicion. Healthcare professionals are just now coming to realise what other professionals have known for years: trust is earned, not assumed. The Trust Crisis represents the first comprehensive survey of the causes and consequences of declining trust in healthcare, and more importantly, it provides suggestions for restoring the trust.

Shore brings together an unparalleled collection of healthcare leaders for this volume. Chapter authors include Donald Berwick, Robert Blendon, Lucian Leape, and George Lundberg. The book also features an introduction by Cokie and Steve Roberts. Causes, consequences, and cures for the crisis in trust are specifically addressed. Critical areas treated by the authors include:

systemic conditions that lead to medical errors, and remedies for promoting quality of care

outdated modes of doctor-patient communication that hinder compliance

novel modes of interaction to improve satisfaction

patient-centered care and metrics to evaluate its presence or absence

media communication and miscommunication, and new standards for medical reporting

clinical insights applied to the use of human subjects in biomedical research

recommendations for revising medical school curricula and strengthening the peer-review process in medical journals

practical strategies for decreasing the lingering discord between patients, providers, and health plans

While presenting a diversity of topics and opinions, the authors of this volume agree upon a few principles. The trust famine will have dire consequences if it continues unchecked. Healthcare leaders can take measures to improve trust. Regaining trust requires that entire organisations pay closer attention to the "human factors" of healthcare. And perhaps most critical for change, trust-building is not only good medicine, but good business as well.

The Trust Crisis in Healthcare

Causes, Consequences, and Cures

Edited by David A. Shore

Introduction: Reflections on Trust, Cokie Roberts and Steven V. Roberts
Part I. Trust and Mistrust: The Big Picture
1:The (Sorry) State of Trust in the American Healthcare Enterprise, David A. Shore
2:Why Americans Don't Trust the Government and Don't Trust Healthcare, Robert J. Blendon
3:Skeptical Patients: Performance, Social Capital, and Culture, Pippa Norris
Part II. Quality and Safety: The Basics of Trust
4:Building Quality in the Healthcare Environment, Donald M. Berwick
5:Medical Errors and Patient Safety, Lucian L. Leape
6:Assessing Quality: Today's Data and a Research Agenda, Christine G. Williams
Part III. Who Can Be Trusted?
7:Patients' Trust in Their Doctors: Are We Losing Ground?, Dana Gelb Safran
8:Healthcare Research: Can Patients Trust Physician Scientists?, Greg Koski
9:Medical Education: Teaching Doctors to be Trustworthy, Jordan J. Cohen
10:Trustworthy Information: Medical Journals and the Internet, George D. Lundberg
11:Trustworthy Information: The Role of the Media, Trudy Lieberman
12:Confusion at the Table: Can We Trust That Our Food Is Healthy?, Walter C. Willett
13:Trust in Vaccines, Marie C. McCormick
14:Trust in the Trenches: Developing the Patient-Physician Dyad in Medical Genetics, Susan P. Pauker
Part IV. Building Trust in the Business of Healthcare
15:Gaining Competitive Advantage in the Health Care Marketplace by Building Trust, David A. Shore
16:The Changing Relationship Between Health Plans and Their Members, Charles M. Cutler
17:Building Trust in a Healthcare System, Michael J. Dowling
18:Building Trust in the Clinician's Office and at the Bedside, Richard Toran and Howard King
19:Conclusion: Trust in Health Care, Trust in Society, Marc J. Roberts