Nearly everyone who met my wife Susan trusted her. Toward the end of her life, she described what she believed to be the three key factors to establishing trust. Number one is cultivating a genuine curiosity about others, seeking to understand them on their own terms. Number two is practicing kindness, something that costs nothing and creates feelings of safety and affection. Last, assisting others—especially those with the greatest needs—with one’s time, skills and resources.
Trust is built not when you give back to those who can give back to you but when you give back to those who cannot.
Trust is essential for good health care delivery. Without it, chronic disease management—including prevention, disease reversal or overall well-being—cannot be accomplished.
Patients ask, “Does my clinician hear me? Are they going to know what I need, even if I don’t? Will they be responsive when they’re needed most? Have they developed a plan and a strategy for what matters most to me?”
They also seek out health care providers who are honest and authentic, asking “Do they tell me accurately about what is most important to my situation and to me as a person? Do they speak the truth?”
Good science is rigorous and relevant
Trusting our health care providers requires that we have trust in science. But not just the type of science that comes down from academic scientists, researchers and regulators. Good science also must be personally relevant, that is, apply to what matters to the patient—it’s about the right fit for the right person at the right time.
When goals don’t align, patients seek alternatives
Unfortunately, many decision-makers across the health care spectrum (industry and hospital leaders, payers, investors, etc.) have different goals and are looking for different types of evidence than patients.
Those developing drugs and devices are seeking profit and the FDA approvals that allow them to market and sell their products. Those paying for these interventions (like insurers or employers) are looking at their cost and whether they will significantly improve health at the least cost.
Clinicians and patients are primarily looking for safety, ease of delivery and rate of effectiveness—the probability of getting better. Patients also want a good experience. In fact, they may want more than just treatment of their disease. They may want to feel well and to live longer.
Unfortunately, well-being doesn’t always come from a research paper or a prescription bottle. And when patients aren’t experiencing a good quality of life, they may look elsewhere, often turning to health influencers, alternative medicine and wellness industries. The public pays more than $2 trillion for wellness practices—almost half the amount of total U.S. spending on standard medical care.
What patients are seeking overlaps with what physicians say they want to provide—but often cannot.
A recent McKinsey report shows that the public seeks out wellness treatments in five categories: nutrition and supplement advice, treatments for beauty and youthfulness, prevention and longevity interventions, better wellness experiences, weight management and mental health services. The scientific and medical communities have failed to provide what patients are seeking in these areas, and this is one reason that the public’s trust has declined.
Broken trust and the AI factor
I thought about my wife’s definition of trust while at the Summit for HealthCare Transformation in 2025. At the seminar, leaders from around the country discussed ways to transform the U.S. health care system into one that focuses more on healing and whole person care in alignment with the mission of my organization, the Healing Works Foundation.
While a large part of the discussion was focused—as it often is these days—on AI, the conversation soon turned to the concept of trust as the key ingredient in such a transformation.
Most of the presenters and participants agreed that AI had tremendous potential for both good and harm. Its potential depended on how those developing (and profiting) from it heard from and listened to those who would be using it. Participants agreed that in health care, the patients for whom it was being designed and the professionals who would make the most use of it needed to be able to trust it.
Patients need to know that they can trust AI to protect rather than harm them, that AI will truly know them rather than pretend to know them, and that AI will help them with what matters most in their lives.
For professionals like me, the trust questions are a bit simpler: Will AI reduce the time I spend in the evenings documenting care when I should no longer be working? Will time and cost savings realized as a result of AI mean that I’ll be asked to see more patients in less time? Finally, can I trust AI to provide me with good evidence?
These questions remain unanswered.
Trust’s role in transformation
Without trust, transformation cannot occur no matter how much money, technology, science or compassion we have.
So, as we seek to transform health care, it’s important to remember my wife’s lessons about creating trust. Be curious, be kind and be willing to give to those who cannot pay you back.
Photo by Bermix Studio on Unsplash