The COVID-19 pandemic has passed, but it has left an unforeseen consequence - it has affected patients' confidence in health systems as a whole; making health seen through a political lens. But health experts are optimistic that humane, more empathetic, and understanding care will remedy this problem.
The healthcare world has always had trouble demonstrating and instilling confidence. Patients also always had trust issues and after approximately 3 years, the medical and health industry faces patients who are exhausted by the safety measures of the pandemic, not to mention decades of mistreatment of people of color, and these patients have been asked whether or not to follow their doctors' advice, whether that advice related to vaccines or other types of treatments.
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Despite politics influencing health, it cannot lean to either side. And to many healthcare professionals, including Gregory Makoul, Ph.D., director of transformation at patient experience consulting firm NRC Health, “There is a pervasive narrative that people of certain political persuasions do or do not trust authority or science,” he said.
Just look at the vaccination rates, and we notice that it can be politically divided between vaccinated being mostly red, and unvaccinated being mostly blue. In the same way, we can politically divide people who have adopted pandemic security measures (wearing a mask and social distancing) and those who have not.
While these surveys can be illuminating, Makoul said what happens inside the health clinic and in the exam room is a better indicator of whether patients trust their providers or not, and he has the numbers to prove it.
The NRC Health surveyed 680,000 U.S. healthcare consumers in April 2022 on their trust in their physicians and the broader healthcare industry and found that partisan politics makes very little difference when it comes to that trust. Crossing the survey information with the voting demographics for the year 2020, the results showed that the lowest confidence index was with the most conservative red voters, although this result confirms the “generalized narrative” that Makoul mentioned, he noted that similar results were shaken when looking at communities that report high levels of trust. That is, the political position of patients does not matter when it comes to your confidence as a patient.
"Our research is showing that it's more important to think about human understanding and empathy than political persuasion when it comes to trusting healthcare providers," said Makoul. "It is not the red or blue political ecosystem that will determine the confidence that a professional passes, but the relationship he builds with his patient. What happens during the consultation? Did the doctor treat the patient as a unique person?" Makoul believes that returning to treating patients with humanized care and with more understanding will help to remedy the problems of trust on the part of patients.
Another important point is the organization of health professionals, for example, with an electronic medical record it is easier to share information with the patient, thus showing promptness in care, and Ninsaúde Apolo for health clinics can help you with that.
Building trust inside the exam room
Despite the patient's trust in the health systems, clinics, professionals, and even hospitals, the percentage of approval and trust is still below 50 points. There is room for trust to grow, and it is the health professionals who need to communicate individually with people who do not trust them or with public health advisors; as only clear communication can improve this aspect.
Trust may be improving in clinical spaces, but it's such an essential form of social tool that it's still critical for clinicians to understand better how to build it. According to Makoul, this starts with empathy and human understanding.
One of the most recent and best examples that can be given is the case of vaccines. For example, a patient who did his own research online. And that's not new, in 2018, Merck Handbooks reported that more than half of physicians are meeting with patients who bring in external surveys, and 97% of them said that patients are accessing incorrect information. This makes the patient's visit more complicated, as a doctor needs to deconstruct the wrong information that the patient has already absorbed, and clarify the doubts correctly, but it is important for the practitioner to be empathetic in this process and remember that patients are just scared and anxious, which is why they ended up consulting outside sources in the first place.
“It's important that the physician or other member of the clinical team tries to put things in perspective for the patients,” said Makoul. “I don't think saying 'you're wrong' is a winning strategy, but saying 'you need to think about the source of the information' is. Please acknowledge that I respect your personal opinion, but I'll tell you what I know and what I think.'”
Physicians can use human understanding to build trust in addition to addressing medical misinformation. Studies have shown that patient confidence decreases when they have a bad interpersonal encounter when the doctor disregards their needs or fails to recognize their circumstances. “That means taking into account what the patient is experiencing, as well as listening to what the patient is trying to achieve before coming up with a treatment plan. Deep down, it means caring for you as you, not someone who looks like you or sounds like you or is just in your group or segment, but you, as a unique person. And doing that for each patient is a pretty straight line to achieving equity.”
Building people's trust in government health
Trust is improving in clinical spaces, but things are looking bleak for other health services or health-adjacent entities such as the federal government and public health agencies.
“During the pandemic, public health messages were extremely confusing and it was very difficult for people to understand 'What are you asking me to do and why are you asking me to do this?'. “It didn't help to have important people, whether from the government or the public health system, if they weren't speaking the same language.”
The concept of human understanding need not be exclusive to the clinical space. Public health agencies, from the federal to the local levels, must work to truly understand their audiences, their needs, and their concerns, to create messages that are more empathetic and easy to understand.
Ease of access to information
Providing patients with easy access to their health information can improve patient engagement and consequently, improve their trust in the healthcare professional. However, recent findings have revealed that 60% of consumers do not have adequate access to their patient data, according to a survey conducted by Propeller Insights.
The survey of just over 1,000 patients across the United States showed that patients take a keen interest in their own medical records and prioritize healthcare providers that offer greater access to patient data. Under HIPAA - Health Insurance Portability and Accountability Act, patients have an inherent right to access their own health information. Access to records can enable active participation in patient care, helping patients ensure that their provider has complete information.
Healthcare providers who offered patient portals and access to clinical notes saw a difference in patient behaviors. Previous studies have highlighted that patients with access to health information will later mention the notes during clinical encounters, highlighting gains in patient involvement and engagement.
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