In Providers We Trust 7/10/12

I ended up taking a not-entirely-planned hiatus from blogging last week with the holiday and swarms of out-of-town guests, on top of a new product launch and user hand-holding that ended up being more time consuming than expected. I hope everybody enjoyed the holiday and survived the heat, which was pretty much unbearable. I made the interesting decision to smoke chickens for a BBQ on the 4th and it was not pleasant to be near the grill on a 100-degree day. The upside is that I cooked way too much and I’ve been eating varieties of smoked chicken for the last week.

Last week my kids had all sorts of questions about Independence Day and wars and kings and queens. Somehow we got to talking about "In God We Trust," I think because somebody read it off of a dollar bill. I was unaware of this, but "In God We Trust" was established by law as the US motto by President Eisenhower in 1956. Then over the weekend, when browsing provider-related topics, I stumbled on a couple of articles about a Gallup poll from last December. The poll surveyed participants about perceptions of honesty, ethics, and trust for different professions. In a roundabout way, this is how I came to this topic and title.

I hadn’t seen the Gallup poll when it was released, but it affirmed what seems to increasingly be the sentiment — or I hope it is the sentiment — around engaging patients and increasing their adoption of new, patient-centered technologies. Basically the poll affirms that providers, be they nurses, doctors, or pharmacists, should be front and center in engaging patients because patients trust them. Providers prescribing apps is something I’ve written about before. The poll also found Members of Congress to be held in lower esteem than lobbyists and used case salespeople.

When asked to rate 21 professions in terms of honesty and ethical standards, the top three in order were nurses, pharmacists, and medical doctors. The medical professions were pretty far ahead of high school teachers, police, and clergy, the next three on the list. I didn’t know this but apparently nurses are always at the top of this list and pharmacists and doctors are close behind. This year the poll found trust in doctors to be higher than ever before, dating back to 1976.

You’d think, or at least I thought, that the general public was losing faith in doctors as pundits argue about them making too much money or medical errors are more widely reported. This is not to say that doctors aren’t held in high esteem, but I’m surprised to see the ratings at an all-time high. That’s a good thing for doctors and a good thing for patients.

I think ratings for doctors are high in part because of the nature of the profession (the whole caring for people thing) and in part because of the perception of the other players in healthcare. I think organizations like payers and pharma help ratings of doctors, and nurses and pharmacists for that reason, as the perception is that providers are on the patient side against what many see as the bad guys. I also think payers and pharma aren’t humanized or individualized in the way that providers are, which also helps provider ratings and hurts perceptions of payers and pharma. As an example, I’m not sure opinions of Retail Pharmacy (Walgreens/CVS) would be as high as individual pharmacists or the profession of pharmacists. It’s also why Walgreens move to individualize pharmacists and create a one-to-one relationship between pharmacist and patient is such a smart move.

What I also took away from the Gallup survey, aside from looking to providers generally as a way to engage patients in technology and services, is that we should be looking specifically at the roles nurses and pharmacists can play in this. I tend to focus on doctors, but I’m also a big fan of retail pharmacy as a point of access to patients and nurses as providers that often, especially on the inpatient side, spend more time with patients. And, practically speaking, nurses are cheaper than doctors. Cheaper and more trusted, at least in this survey.

I do think there are some limitations in generalizing this survey. Asking for trust in a profession is different than trust in say, clinical judgment or opinions about health-related services. But, overall I think it’s an indication that the public will listen to what providers say, though it might not be an indication that they will follow through. That’s why health apps and services need to combine both the initial sell (provider referrals) with aspects that continually engage patients. I think the aspects that will continually engage patients also involve provider integration but also relate to social and gaming components.

Travis Good is an MD/MBA involved with health IT startups. More about me.

  • David Brooks


    I think you do a good job pointing out a number of reasons why people might rate nurses, pharmacists, and doctors highly. I’d guess that another reason – and the major one in my opinion – is that people are generally financially detached from these professionals. In other words, most people don’t understand, in typical consumer terms, how they are paying for the services provided by these professionals. From their perspective, these are just altruistic individuals helping out during a time of need. I may be completely wrong, but I suspect the more people are responsible for paying the $10,000 procedure by the doctor in question, the more they are going to question the motives and the quality of the physician.

  • “Providers” have earned this type of trust over many years of being independently engaged in the “caring for people thing”. Once you begin to exploit this trust and put it to good use in advancing all sorts of other entities’ agendas by making providers subservient to external interests, the trust will evaporate into thin air, and at least for doctors, all the material and social rewards that come with trust and respect will diminish as well. Some things were not meant to be exploited, even if we think it’s for a good cause.

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