The European Journal of Public Health has published an interesting article about ‘Trust Relations in Health Care.” (Thank you to my friends at the Alberta Pharmacists’ Association for passing this on).
As you might have expected, the answer to has trust between health professionals and patients changed over the years is yes. Yes, that relationship has changed. And it is for all the reasons you might guess: because of negative media reports of health care incompetence, through the dismissing of the classic ‘expert’ model, by the growth of the patient voice and advocacy efforts. I think the rise of chronic disease has also led to a generation of patients who aren’t interesting in having things done to them or for them. They want to retain control of their own health care, and partner with health professionals.
I think it takes an open-hearted and confident clinician to ask a patient: what works best for you? What do you think? Or, the most scary statement of all: I don’t know.
I have been thinking about how I built trust with Aaron’s pediatrician. I remember the first time meeting his doctor. My first impression was: gosh, she’s a snazzy dresser. My second impression was: wow, look at her sitting cross-legged on the clinic floor in her nice dress, chatting with my two year old boy. She knocked on the clinic door, said hello, and immediately zoomed in on engaging Aaron. She charmed both of us with her approach, which was friendly, open and sincere. (The great thing about pediatricians is that they love kids. I’m not sure the adult health world can say the same thing about their patients).
Of course Aaron’s pediatrician is technically proficient and clinically-competent. The last time he was hospitalized, he got cracker-jack care from her. Her nurse coordinator also does a fabulous job of responding to questions from families, even when she’s swamped with work, which has saved us (and the system) clinic and Emergency Room visits.
I think I trust our pediatrician because she’s presented to me as a person first. She’s a mom, too, and I know that she has three small boys. I know she was a nurse before she became a doctor, and we run into her in our community – at the recreation centre, in the grocery store. I connect with her on a human level. She allowed me a glimpse into her own life as a mom, and this helped form the bond of trust with her. I have to confess: if I trust a health professional, I will do just about anything for them. I am very ‘compliant’ (gosh, I hate that word) for people I trust. If I don’t like you – I’m not very motivated to do as you say.
I think if you communicate that you care about me, I will work extra hard to care for myself. As a patient this is true, and the same applies as the mom of a patient, too.
So yes, I trust Aaron’s doctor. But this isn’t blind trust – this is mutual trust, based on demonstrated caring and the gradual piecing together of a human relationship. And in today’s world of informed patients, trust does need to be nurtured by clinicians, and by patients too. And that might start with sitting on the clinic floor in your snazzy dress.