The Big Story: Physicians’ Trust Continues to Decline
“The risks of a cracking foundation of trust are substantial. Without buy-in from physicians and others both involved in and affected by change, it cannot be successful.”
Trending in the wrong direction
By Isaac Squyres and David Shifrin
3-minute read
What do you do when the most trusted voices in healthcare don’t trust the leadership of their own organizations?
You’ve long known that a sense of distrust has infected institutions across the country. Healthcare is not immune.
We conducted a checkup recently with more than 400 physicians for the 2024 edition of our annual State of the Physician Workforce survey.
What’s the diagnosis? It’s not healthy.
Physicians say job satisfaction is down. There’s a distinct lack of trust in their leaders’ honesty, transparency and decision-making that continues to move in the wrong direction. There’s broad favorability towards unions, with mistrust in leadership being cited as a key reason.
And physicians at not-for-profit organizations tend to be more skeptical than their counterparts in private practice or at investor-owned organizations.
It’s not just the doctors. These trends are echoed in our 2024 State of the Nursing Workforce and in our years of tracking data with the American public. For the American workforce writ large, Gallup also has numbers showing that about half of workers are “watching for or actively seeking a new job.”
Why does this matter to you? You know why. Every healthcare leader wants happy and satisfied physicians and nurses, of course. It strengthens retention, improves engagement and makes healthcare delivery easier.
But, also this: Physicians and nurses serve as a dam between provider organizations and public skepticism. Whatever people think of hospitals, insurance companies, pharma and even hospital leaders, they know and trust the people providing them care.
Every time we ask the public “who do you trust the most” on healthcare issues, the answer is always physicians and nurses.
When those caregivers are feeling good, they’re powerful allies and advocates for healthcare organizations. But when they themselves are skeptical, that energy can be turned against hospitals, or into abject apathy.
The result is twofold. First, the positive internal strategic changes many hospitals are already undertaking cannot be successful let alone sustained without trust and buy-in from physicians and others affected by them. Second, the public and other stakeholders – lawmakers, media, public officials with any hand in directing healthcare – are less likely to hear positive stories from those trusted voices on the inside. It turns into, “Well, if they don’t trust their own hospital, why should we?”
Healthcare providers always need allies, advocates and powerful stories. But today we have a new wrinkle: the addition of high-profile public figures being brought forward to lead the healthcare system at the federal level. If appointed and confirmed, Dr. Oz and RFK Jr. will have a bully pulpit and exceptionally large megaphone. And, according to the New York Times, a decent chunk of the American public is receptive to their ideas, many of which are not good for public health or hospitals.
So, what to do? Our survey shows clear opportunities to improve clinician engagement and build back what’s been lost.
The docs say they want open conversation and engagement with leaders, more transparency from their organization and collaborative culture (which many say they already have).
That’s not a surprise. You know it’s important. There’s no silver bullet and it’s not about highlighting your awards for quality of care. It’s relational and communications elbow grease.
Such work has always been important, but today even more so as the national conversation about healthcare continues to shift and not in favor of institutional players…including hospitals and payers.
Taking back the national conversation may be worthy, but also a massive lift for any one hospital or physician practice or even national health system or huge association.
But improving engagement and (re)building trust at the facility and community levels is an eminently achievable goal. Collaborating with your physicians and nurses to chart the path forward for your organization? Doable, meaningful and measurable work.
For a refresher on how nurses are feeling these days, check out the survey we released last month.
Meanwhile, here are some takeaways from our latest physician data.
Trust in leadership has declined
- Less than half of physicians think their organization’s leaders are honest and transparent.
- Less than 60% say their leaders communicate effectively with them or engage them in important decisions.
- Trust in each of these areas has slipped in the past year.
- Older physicians and those at not-for-profit organizations have less trust in leaders.
Job satisfaction has slipped
- The percentage of physicians expressing high levels of job satisfaction is down 14 points, with older physicians less satisfied than younger ones.
- Those in private practice are far more satisfied.
- Six in 10 feel loyal to their organization, but barely half express loyalty to their leaders.
Physicians feel favorably towards unions
- More than six in 10 have a generally favorable view of physician unions, even though only 1% are currently part of one.
- Distrust of leaders is the top reason cited for why physician unions have gained momentum.
Collaborative culture is a priority
- Physicians say flexible scheduling would be the top factor in choosing a new job, but a collaborative environment is close behind.
- Two-thirds have a positive view of working with APPs. Collaboration and communication are cited as reasons.
- Awards and rankings – often a focus of reputation building and recruitment efforts, are seen as secondary.
Download the full report, which includes all the data and advice on how to deepen engagement with your physicians. After all, healthcare is local, and personal. The best work you can do today is local and personal, too.
Contributors: David Jarrard, Courtney Kelsey, James Cervantes, Emme Nelson Baxter
Image credit: Shannon Threadgill
