Article originally published in Physician’s Weekly on July 10, 2025
In recent years, the United States has witnessed a significant decline in public trust toward healthcare providers, hospitals, and healthcare systems. This erosion of trust poses serious challenges to patient care, public health initiatives, and the overall efficacy of the healthcare delivery system. Understanding the drivers of this decline and devising strategies to restore the foundational patient-physician relationship are critical to rebuilding confidence in healthcare.
Declining Trust
A comprehensive joint survey by Massachusetts General Hospital and Harvard Medical School illustrates the scale of the problem: in April 2020, 71.5% of US adults expressed confidence in physicians and hospitals; by January 2024, that figure had plummeted to 40.1%. This decline is consistent across demographic groups, indicating a widespread loss of confidence in the healthcare system.
Several forces lie behind this trend. The COVID-19 pandemic—marked by politicized public health measures and pervasive misinformation—fueled public skepticism. Patients also increasingly perceive the healthcare system as prioritizing self-interest over patient welfare. In a recent poll, 68% acknowledged believing that provider organizations put their own interests ahead of their patients’. Such perceptions corrode the trust that is critical to effective healthcare.
Administrative Burdens & Physician Burnout
Physicians now devote a large portion of their workday to non-clinical tasks, such as handling prior authorizations, managing inboxes, and navigating patient portals. A study published in Health Affairs found that nearly half of weekly inbox messages in electronic health records (EHRs) originate from EHR algorithms. These administrative tasks consume a significant amount of time and contribute to physician burnout. Primary care physicians spend more than half of each day—and additional time after clinic hours—interacting with the EHR. While clinicians focus on screens, opportunities for meaningful dialogue with patients diminish, depersonalizing the trusting patient-physician relationship and ultimately compromising the healing process.
Suspicion of Corporate & Government‑Run Care
A study in Public Health Reports suggests that many patients distrust both corporate and government-run healthcare. Respondents cited financial motives—for example, pharmaceutical companies promoting high‑priced therapies and compensating clinicians to prescribe them—as a significant factor undermining their trust in the healthcare system. Government-run programs are viewed as prioritizing cost containment over patient care quality, raising fears that budget pressures, rather than clinical need, drive decisions, eroding confidence in the system’s ability to meet their healthcare needs.
Paths to Restoring Trust
Restoring healthcare trust requires a multifaceted approach:
- Enhance communication.Prioritize clear, empathetic listening and communication, ensuring patients feel heard and understood.
- Increase transparency.Provide clear information about treatment options, costs, and potential outcomes to empower patients and rebuild trust.
- Address systemic issues: Healthcare institutions must address systemic problems, such as administrative burdens that hinder the patient-physician relationship.
- Foster continuity of care.Encourage long-term patient-physician relationships to foster trust and enhance health outcomes.
- Counter politicization and corporatization.Actively engage in advocacy and education to counteract corporatization and politicization and restore confidence in medical guidance.
Trust: The Bedrock of Effective Care
The decline in trust within the healthcare system is a pressing issue that demands immediate attention. By restoring the patient-physician relationship through improved communication, transparency, and systemic reforms, the healthcare industry can begin rebuilding the trust essential for effective care. A concerted effort to address these challenges will not only enhance patient confidence and health but also strengthen the nation’s overall health.
Any views and opinions expressed are those of the author(s) and/or participants and do not necessarily reflect the views, policy, or position of Physician’s Weekly, their employees, and affiliates.
REFERENCES & ADDITIONAL READING
Northeastern Global News. Accessed July 10, 2025.https://news.northeastern.edu/2024/08/07/trust-in-physicians-hospitals-research/
Tai-Seale M, et al.Health Aff (Millwood). 2019;38(7):1073-1078. doi:10.1377/hlthaff.2018.05509
Richmond J, et al.J Gen Intern Med. 2017;32(12):1396-1402. doi:10.1007/s11606-017-4172-1