Industry Voices—Return to trust: How lack of transparency can damage relationships in healthcare

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One-third of consumers have not moved forward with medical treatment because of a lack of trust in the care they were getting. (andrei_r/GettyImages)

We live in a transactional society. As a consumer, if you want to buy something, you go online or to the store, you find out how much it costs, you buy it. It’s a pretty simple process of getting the things we need—until it comes to healthcare.

The healthcare landscape today can be a mystifying maze for patients disoriented by a lack of transparency. Healthcare costs, and why they vary so much, are hard to decipher. Easy to understand information and cost details about procedures or medications patients need is often difficult to get. And that’s a problem.

Survey examines attitudes around variability and transparency

Think about this for a minute. One-third of consumers have not moved forward with medical treatment because of a lack of trust in the care they were getting. 

RELATED: Survey finds more than 9 in 10 people say doctors are the most trusted professionals

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Diana Nole
(WoltersKluwer Health)

That’s what we found when we commissioned an independent healthcare survey with more than 1,800 respondents including consumers, physicians, nurses and hospital executives. We wanted to look at whether people could spot where variability exists in care and what happens when there’s less visibility between care and costs.

We know transparency is making national headlines, with costs in particular being a primary pain point. What we didn’t know is just how pervasive it is, from both a macro and micro level. As an example, 87% of hospital executives stated that healthcare pricing can be very cloudy, with 1 in 5 (21%) noting that more than half of patient information gets lost when transitioning to other care settings. Transparency and knowledge, these two factors alone, go a long way toward eroding the trust between patients and their healthcare providers and institutions.

How is trust established, and why is it important?

In his 2017 paper, Carlos Pellegrini, M.D., a noted surgeon, talks about how trust is built over multiple interactions. In the healthcare world, it’s an intricate fabric woven with the patient’s perception of the physician’s skills, interpersonal attributes and values, as well as the patient’s impression of how the system works, including the reputation of the institution. Trust has been shown to increase the likelihood of adherence to treatment recommendations and to increase satisfaction with the physician’s care.

RELATED: Relationships top predictor of patient loyalty

Trust made an appearance in our study as well. For instance, 78% of patients will forego care at a nearby institution to go to one further away with a better reputation. We saw that patients are willing to neglect filling prescriptions or to look for help elsewhere when they don’t trust the care they have or can’t afford it. The lack of transparency between cost and outcomes means some patients will just opt out—about one-third of patients will halt care altogether if they don’t feel a level of trust. Some 43% indicated they wouldn’t move forward with treatment due to cost concerns. Millennials in particular are showing they will forego needed procedures or treatments—61% will refuse treatment due to cost considerations, compared with 31% of baby boomers.

So … is there hope for this relationship?

We think so. It may sound like a dire situation, patching things up between patients and their healthcare providers and systems. But imagine if things could be different. What if the status quo of unwarranted variability in care, lack of transparency and the disappearance of trust could be blown out of the water? What would that take?

RELATED: Who do Americans trust? Their nurses, doctors and pharmacists, Gallup poll finds

It starts with something so simple: trust. We know that patients want a collaborative relationship with their providers, one that’s based on empathy and understanding. That can be a challenge when about 88% of front-line caregivers believe they need more comprehensive patient information if they’re to deliver better patient care. Nearly everyone in the survey agreed that there’s a huge opportunity in improving care handoffs and better aligning care teams so every member is practicing based on the same information.

So what can you do? We know that correcting variability and improving transparency doesn’t happen overnight. It’s not an easy fix. A great first step is to provide more comprehensive and useful patient and cost information at the point of decision-making. Focus on nipping variability in the bud—where it starts, with training and educating healthcare providers. Embrace the technology that can result in better care.

Proactively addressing transparency and variability goes a long way toward building trust, which in turn positively impacts patient outcomes, medical errors and, ultimately, the bottom line.

Diana Nole is CEO of Wolters Kluwer Health.

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