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from the industry: health care based on trust is good for everyone

if a patient trusts their physician and feels they can be honest without judgment, they are more likely to provide information that can help them get the most appropriate care.

by jennifer zeifman

jun 27 2023

4 minute read

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millennials are less trusting than boomers

canadians gave our health-care system the top score in trust, but the number has dropped from 63 per cent to 58 per cent in the past three years. getty

there are few things that are more critical to a healthy and effective relationship between a doctor and patient than trust. in fact, the absence of trust can have dire consequences, affecting things like adherence, the willingness to manage disease, and in the end, the likelihood of a positive outcome.

it’s why we study and measure trust each year through our proof strategies cantrust index . one of the largest annual studies of trust in canada, it is conducted every january and uses a 7-point scale to assess varying levels of trust. the last three years of the pandemic have been a particularly interesting period to study trust in our health-care system and in those who work within it.

canadians love to boast about our health-care system, especially compared to the u.s., and overall, we have high levels of trust. but the pandemic has put that under pressure.

when asked which institutions canadians are willing to trust to operate competently and effectively and do the right thing — our health-care system got the top score, ahead of the canadian military, the supreme court and the education system. however, that trust has been eroding slightly year over year, dropping from 63 per cent to 58 per cent in the past three years. this shift isn’t cause for alarm bells, but is certainly something to keep an eye on.

jennifer zeifman is the svp, national lead, health & wellness, at proof strategies. supplied

not surprisingly, the levels of trust in canada’s health-care system vary across the country, possibly because of the disparity of services from province to province. for example, atlantic canadians are seven per cent less likely to trust the system (coming in at 45 per cent compared to ontario, the most trusting province, at 58 per cent). according to an angus reid survey , the atlantic provinces have the worst access to health care in canada, with 37 per cent of atlantic canadians describing “chronic difficulty” in getting the services they need, compared to 26 per cent of ontarians. the national average was 29 per cent.

trust levels also differ between generations. millennials are the least trusting, coming in at 45 per cent, while the most trusting are boomers at 64 per cent. based on some studies , we can speculate that the reason behind these numbers is the fact that millennials are less likely to have family physicians than those from other generations. in fact, according to statistics canada , in canada, those aged 18 to 34 were most likely to be without a regular health-care provider compared to all other age groups. and in addition to health care, ongoing issues such as climate change and unaffordable housing create a new paradigm that could be a barrier to trust with younger canadians.

trust in medical doctors to provide reliable information is dropping

we know that some of the key issues facing our health-care system continue to be wait times, lack of family physicians, nursing shortages and equal and timely access to medications. some governments appear to be tackling these issues. for instance, provinces are trying to address challenges related to physician and nursing shortages, which have a direct impact on patient care. the solutions, however, often seem inconsistent and even reactive. unfortunately, the uncoordinated and almost competitive atmosphere threatens to impact trust levels even more.

though we do need solutions to solve these more complex systemic issues, there is another piece of the patient care puzzle where trust levels are equally as important — those with individual care providers, the medical doctors. our research shows that medical doctors topped the list of trusted individuals to provide reliable information — ahead of family and friends or educators. however, trust in physicians is also eroding. it peaked in 2021 during the height of the pandemic and has fallen since — dropping from 81 per cent to 73 per cent. the frustration among canadians caused by the pandemic has had an inevitable impact.

while 73 per cent is still a high level of trust, it is a critical number as the trust that one has with their physician can directly lead to better health outcomes. if a patient trusts their physician and feels like they can be honest without judgment, they will be more likely to provide information that can help them receive better care.

engaging patients can build trust

one way to accomplish this is by working to humanize health care. a simple shift from directive behaviour to empathetic engagement can go along way in terms of helping people not only develop trust in their health-care provider, but also ensure that they have the best chance at receiving treatment that meets their needs.

for instance, when patients are having difficulty following instructions — attending appointments and taking their medication as prescribed, for example — they would benefit from a health-care provider who uses an empathetic approach, engaging them in an open, non-judgmental conversation. this is how solid, trusting relationships are built. in fact, academic research has found that empathy is a key driver of trust, along with ability and integrity.

and while an engaged approach may take more time initially, it’s worth it to help patients feel confident in their care and secure in their treatment plan, and more motivated to make change and improve their health.

it’s time that canadian health-care leaders take note and ensure that all aspects of our health-care system is rooted in trust. it’s a strong and resilient resource that benefits everyone involved.

the annual proof strategies cantrust index , now in its eighth year, is a leading source of research and understanding of trust in canada.

jennifer zeifman is svp, national lead, health & wellness, at proof strategies with over 25 years of experience specializing in health care communications.

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if a patient trusts their physician and feels they can be honest without judgment, they are more likely to provide information that can help them get the most appropriate care.

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