Is the Global Implosion of Trust affecting doctors?

Image of trust collapsingTrust between people and organisations is in crisis. An unprecedented global implosion of trust has occurred over the past year. That’s the conclusion of the 2017 Edelman Trust Barometer. This is a study into the attitudes of some 33,000 participants across 28 countries which has been conducted annually since 2000. Edelman have found that two thirds of the countries in their study are now populated by a majority of ‘distrusters’. They note that this is a significant acceleration of an ongoing trend. The UK has become one of these predominantly distrusting populations. A distrusting population is described as one where over 50% have lost trust in business, government, media and non-profit organisations – such as the NHS.

There are a multitude of drivers of this change. Everything from the 2009 financial crash and the rise of terrorism to public scandals and the ‘echo-chambers’ of social media. The symptoms are all around from the rise of fake-news to last year’s junior doctor’s strike. Peers are now considered to be as credible as experts.

What are the implications for doctors?

The symptoms of the collapse go beyond the high level trends and events. They affect our everyday social attitudes and culture with Edelman suggesting the risk of a continual downward spiral.

  • Loss of trust in institutions leads to lack of belief in the system
  • Lack of belief makes us more vulnerable to fears
  • Fear further erodes trust
  • A vicious circle of decline becomes established
  • The culture of distrust grows

Strong working relationships with patients and colleagues are essential for good medical practice. To paraphrase Stephen MR Covey: Change happens at the speed of trust. Change in itself takes many forms. Successful consultations, treatments, leadership, teaching, appraisals, referral to another colleague and numerous other interactions are examples of everyday change activities. Symptoms of the trust implosion which you could experience in daily practice could be:

  • the patient who is more influenced by their friend’s opinion than by your own
  • team members who doubt the motives of their leaders
  • the doctor who would rather “do it myself and that way I know it’s done right”
  • “I won’t believe you till I see it myself”
  • team members who would rather grumble than offer solutions
  • the colleague who will not speak up when they see something that is wrong

So what’s the solution

Trust is, without doubt, a complex matter. We can consider it as an attitude of others or we can consider it to be a competence resulting from our personal behaviours. In the latter, we can take responsibility for the development of our own behaviours.  We can take responsibility for the frequency, quality and openness of our communication. We can ensure our actions match our words with integrity. We can create the space for and invite the opinions of others. We can choose to respond to these opinions in a constructive manner. When the time is right, we can choose to be assertive with consideration to both ourselves and others. There are many other examples. In short, the trust we receive from others is directly related to our leadership, teaching, team and patient communication skills.

If a breakdown of trust can create a vicious circle of decline and negativity, then it follows that the development of trust should lead to a virtuous circle. Such a virtuous circle will have positive impacts for our patients, our colleagues, our organisations and, ultimately, for ourselves.

What steps are you taking to foster the development of trust?

Stephen McGuire – Head of Development, Oxford Medical Training