The healthcare system has always been in the business of earning trust. What’s changed is how many forces are working against it at once.
Seven health system leaders recently identified misinformation — and the crisis of trust it feeds — as the most dangerous trend reshaping their field. Their answers converge on a cycle that public health researchers have documented but that operators say is accelerating. Patients are frustrated by a fragmented system disengage, and disengagement leaves them more vulnerable to the algorithmic misinformation filling the void.
“One of the most dangerous trends in healthcare today is growing disengagement from care, coupled with increasing mistrust in the medical community,” said Erik Mikaitis, MD, CEO of Cook County Health in Chicago. “Patients are being asked to navigate an increasingly complex system, from insurance coverage and referrals to prior authorizations and changing eligibility rules. Recent federal policy changes are making that even more difficult for individuals who rely on coverage through insurance marketplaces or Medicaid.”
What begins as administrative friction — a confusing prior authorization, a referral that falls through — can harden into something more fundamental. Dr. Mikaitis described watching skepticism toward science-based medicine amplified at the national level, visible in declining vaccination rates.
“The harder it is to access and navigate care, the less people engage with the health system, and the less they engage, the more susceptible they become to misinformation and delayed care,” he said. “Rebuilding trust and making healthcare simpler to access and navigate are among the most urgent challenges facing our health system.”
Matthew Fry, president and CEO of Freeman Health System in Joplin, Mo., said AI tools have added a new dimension to that problem. Patients are turning to AI and chatbots for medical advice and seeking expertise on when to elevate care, and the responses may not be reliable.
“We’re already seeing how reliance on large language models can shape whether people seek medical attention at all, or whether they trust the advice of the professionals trained to give it,” Mr. Fry said. “As these tools become part of everyday life, it falls to all of us — healthcare providers included — to keep our audiences grounded in timely information so they can make sound decisions about their health.”
The answer is not to disengage from innovation but to hold onto what makes healthcare distinct from other industries. Hospitals are intentionally focused on community outreach efforts and tooling clinicians with responses to AI-generated guidance to build trust.
“In the race to innovate, we can’t forget that healthcare is personal,” he said. “The empathy and judgment a provider brings to a patient relationship can’t be replicated by a model, and it shouldn’t be.”
Lance Sewell, president of Orlando Health South Lake Hospital and senior vice president of Orlando Health, has seen the information problem up close among elderly patients — a population increasingly navigating digital platforms not designed with them in mind.
“Untested information being provided on social media and other mechanisms for care of elderly patients seems to be a dangerous trend,” Mr. Sewell said. “The access to the right information and care remains the most dangerous trend.”
Leong Koh, MD, executive medical director of Northwest Permanente, said coverage loss and misinformation are tied together as a big challenge for the most vulnerable population he serves. Patients who are unable to access timely and reliable information will turn to disingenuous sources with their health-related questions.
“Both these issues point to the same underlying reality: when access or trust breaks down, the foundation of preventive care collapses,” Dr. Koh said. “Physician leaders can play a role to address this challenge by advocating for policy changes that increase access, supporting the spread of coordinated, value-based care, and rebuilding trust through clear, evidence-based communication at every touchpoint.”
Patients aren’t the only ones upended by misinformation and lack of trust. Karyn Baum, chief medical officer at UnityPoint Health Meriter Hospital, said the erosion in trust between healthcare workers and the institutions that employ them can be just as damaging. When healthcare workers grow skeptical of the institution they’re part of, they take their skepticism into the community and it grows.
“There has been loss of trust between patients and providers and the system in general, leading to challenges establishing the relationships so essential to effective patient and community care,” Ms. Baum said. “If this trend continues, we will see ongoing burnout, violence, poor quality outcomes, and fewer people entering these fields.”
Ms. Baum said rebuilding that trust will not be a quick or simple project.
“As leaders we need to consider carefully what concrete steps we can take to rebuild the loss of trust among all these groups, knowing that it will take time, patience, and humility,” she said.
In rural communities, declining trust compounds challenges that already exist. Lisa Carter, president of the Southern Region at Ballad Health in Johnson City, Tenn., said recruiting and retention difficulties mean rural systems have less capacity to absorb the strain.
“Because the healthcare system in our country is extremely complex, and the economic principles of supply and demand sometimes do not translate to the system, consumer frustration continues to grow,” Ms. Carter said. “This frustration, coupled with declining public trust, is creating extreme challenges for delivering healthcare.”
Ms. Carter noted that frustration has taken a physical toll on the workforce.
“Far too often we see consumer frustration manifested with violent and aggressive behavior towards frontline care givers,” she said. “This dynamic then compounds the issues with team member engagement. These trends are compounded within rural communities because of the difficulty with recruiting and retaining quality providers and already limited resources. Working to find lasting solutions to these challenges is top of mind for my health system.”
Greg Rosencrance, MD, president and CEO of WVU Medicine Thomas Hospitals in Morgantown, W.Va., said the path forward lies in organizations that hold their mission at the center when the external environment erodes it.
“The organizations that will succeed in the years ahead are those that never lose sight of their mission, continue to innovate with purpose, and earn the trust of the patients and communities they are privileged to serve,” Dr. Rosencrance said.
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