Trust Me, I’m a Doctor: The Anatomy of Trust
“The best way to find out if you can trust somebody is to trust them.” ― Ernest Hemingway
Consider for a moment the qualities of someone you would say you “trust fully,” and someone whom you “don’t trust.” How did you establish these judgments? Though we don’t talk about it often, trust is certainly foundational in our work; trust in ourselves, our care team, our colleagues, the systems we work in, the medications we prescribe, and the equipment we use. And trust in healthcare is fragile these days.
The establishment of trust is also necessary in our relationships with patients. As a Family Medicine resident, I was often struck by the trust patients placed in me, even when making life-or-death decisions. Despite being a trainee, my opinion was sometimes valued even more than my attending’s or a consultant. This prompted me to become a “student” of trust.
During my research, I came across a “trust equation” that has continued to resonate:
Trust = Connection x Competence
Risk
In this equation, “connection” is built through empathy and caring (“I sense you care about me”), while “competence” speaks to demonstrated skill and knowledge (“you appear to know what you’re doing”). The “risk” factor underscores that trust isn’t absolute but varies depending on the perceived vulnerability involved. When someone feels exposed or dependent on another’s judgment, the stakes—and the importance of trust—are higher.
How can we strengthen these pillars in our daily work? Consider starting with small, actionable steps. For example, spend an extra minute explaining the rationale behind a treatment plan or decision. Listen without interrupting when someone shares their concerns. Acknowledge uncertainties openly, showing that you’re committed to working through them together. These actions help build the “relationship” side of the equation, while our regularly honing fundamental skills fortifies the “competence” component.
Ultimately, trust requires more than credentials, clinical skills, or a title; it demands a willingness to engage, communicate, and make oneself vulnerable. Rebuilding trust in healthcare isn’t a quick fix but an ongoing commitment. Continuously revisiting these fundamentals, not just as a theoretical exercise but as a practical approach to our interactions, will help us together find our way forward with our patients and with each other. Let’s give it a try. Trust me, I’m a doctor …