[Re]Building Trust – The 2018 ABIM Foundation Forum

In less than a week, we will convene a meeting of clinicians, patients, advocates, journal editors, health journalists and other health care leaders at the 2018 ABIM Foundation Forum. This year’s Forum is entitled “[Re]Building Trust” and focuses on the role of trust in health care.

The 2018 Forum goals are to examine ways to build and nurture trust against a backdrop of political and social turmoil, and all-time lows in Americans’ trust in institutions across society. In a background paper, we detail why the concept of trust matters in health care and why we are dedicating time to have conversations, presentations and discussion on this topic.

At the 2015 Forum, Bringing Culture Into Focus, Dr. Jo Shapiro, Director of the Center for Professionalism and Peer Support at Brigham and Women’s Hospital, said, “professionalism is about trusting and respectful relationships,” a definition that has greatly influenced our organization. Professionalism cannot occur without trust—trust not only between patients and their physicians, but also between physicians and their organizations and between society and the profession as well.

There is no doubt that trust is fundamental in health care. While researching this year’s Forum topic, I’ve come to realize that trust is also intrinsically linked to the Foundation’s work. For example, since we launched the Choosing Wisely campaign in 2012, our goal has been to facilitate conversations between clinicians and patients about unnecessary tests and procedures. The only way these conversations can occur is if there is underlying trust between both parties.

In recent years, we have seen an incredible erosion of trust throughout multiple facets of society, including health care. As members of a profession based on science and facts, physicians are suddenly finding themselves facing challenges to their authority that would have been inconceivable in earlier eras, such as the debate over vaccinations. An organization like ours—with a mission of advancing professionalism—is seeking to respond to this challenge by creating a space in which stakeholders can come together both to better understand the decline in trust in health care and its effects on professionalism and to explore strategies to rebuild it.

I am going to the meeting with initial strategies in mind. My pre-conference thoughts focus on:

• building reliable systems that produce reliable results;
• demonstrating compassion and integrity;
• eliminating conflict of interest;
• increasing transparency; and
• employing intrinsic motivation rather than external rewards.

I am also dealing with the trust issue on a personal level. Having just moved to Philadelphia from New Jersey, I am looking for a new physician after being a patient of my previous physician for over 25 years. I am thinking of all of the points listed above as I go through my search, including how my physician will be paid. I know I will walk into that first visit afraid and anxious, asking myself if I can trust this stranger with my health, knowing that as I age I will need more health care than in the past.

I look forward to hearing suggestions and strategies from others in the field during the course of the Forum, and I expect the discussions will continue long after the meeting ends. It is imperative that this work continues. For the Foundation, this meeting is just the start.

Daniel B. Wolfson
EVP & COO, ABIM Foundation