Rheuminations: How to Counteract Patients’ Eroding Trust in Healthcare

Structured opportunities for learning are also essential. Role-playing scenarios like objective structured clinical examinations (OSCEs), reflective writing exercises and longitudinal mentorship programs can help fellows and other trainees develop their communication and relationship-building skills. Encouraging trainees to seek feedback from patients and peers creates a culture of continuous improvement, where trust building is seen as an ongoing process rather than a one-time achievement.

Finally, we must acknowledge the systemic factors that influence trust. By the time of their graduation, fellows need to understand how social determinants of health, healthcare disparities and institutional biases affect their patients’ experiences. By integrating these discussions into curricula throughout the nation and the world, we prepare trainees to navigate the complexities of trust building in diverse, real-world settings.

Conclusion: Stitching Together Our World

As the universe continues its slow, inevitable expansion, we are left to contend with the more immediate fractures in our own world at this very moment. Loneliness, mistrust and misinformation threaten the fabric of our society and our healthcare systems. As rheumatologists, we have the tools—and the responsibility—to stitch together these fraying threads for the benefit of our patients and ourselves.

Through our relationships with patients, our engagement with communities, and our steadfast commitment to truth (regardless of popularity), we can create a tapestry of trust and connection. It is very clearly not an easy task, nor one that will be completed in a single year, or even a single generation. But with each small act of listening, educating, and advocating, we move closer to a world that is not only healthier but also more unified.

Yes, the universe may keep inexorably expanding, but so too is our capacity to care, to connect and to build trust. Let’s not let that opportunity slip away.

Bharat Kumar, MD, MME, FACP, FAAAAI, RhMSUS, is the director of the rheumatology fellowship training program at the University of Iowa, Iowa City, and the physician editor of The Rheumatologist. Follow him on X (formerly Twitter) @BharatKumarMD.

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