Physicians say COVID-19 has lowered their trust in organizational leadership and healthcare at large

A recent poll of physicians and the general public found lower trust across the U.S. health system but steady or increased faith in the individuals who are providing care. (Getty Images/DNY59)

Physicians and consumers’ trust in the U.S. healthcare system dipped over the course of the COVID-19 pandemic, as did doctors’ trust in healthcare organization leadership, according to a recent survey.

On the other hand, consumers’ trust in doctors themselves has generally held steady during the pandemic, and physician respondents often said their trust in nurses or fellow physicians had increased over the course of the public health emergency.

The poll was conducted by NORC at the University of Chicago on behalf of the American Board of Internal Medicine Foundation. The research organization distributed its general public surveys to a sample of 2,069 adults between Dec. 29, 2020, and Jan. 26, 2021, and its physician survey to 600 clinicians between Jan. 22, 2021, and Feb. 5, 2021.

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For physician respondents, the decline in healthcare system trust was most prominent among those who already held a poor view of the system prior to COVID-19.

The pandemic also had a net negative impact on physicians’ trust in health insurance companies and government health agencies, but slightly increased the overall sample’s faith in hospitals and pharmaceutical companies.

Even outside of the context of COVID-19, about a third of physicians did not say they trusted their own organization’s leadership. Roughly one-third and half of the respondents also did not signal trust in home health care providers and skilled nursing facilities/long-term care, respectively.

Among the broader public, reported trust in clinical staff and hospitals was substantially higher compared to healthcare organizations with less direct patient interaction, such as insurers or pharmaceutical companies.

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Those who didn't trust their doctor most often said that their practitioner hadn't spent enough time with them, did not know them or don’t listen to them. There were also disparities in primary physician trust among different demographics, with trust trending lower among those who were younger, poorer, Black or Hispanic.

Nearly two-thirds of consumers said they would somewhat or completely trust their physician to distribute a COVID-19 vaccine. Those responses were highest among patients who were Asian or white as well as among those who identified as a Democrat.

Survey data collected by the Harris Poll earlier in the pandemic similarly suggested that the public viewed clinical staff and nationally recognized hospital systems as more trustworthy sources of information than federal health agencies.

Several viewpoints published in the December 2020 issue of JAMA also highlighted the toll misinformation, political interference, racial disparities and a novel virus have taken on trust across healthcare and outlined potential strategies to rebuild those relationships.