Seven Ways that Peer Support Specialists Can Address the Trend in Distrust of Healthcare Professionals and Organizations
Trust is essential in healthcare, but a growing number of people report not having trust in their providers, raising calls for new efforts to “rebuild” the public’s trust in healthcare institutions and providers (Isaacs, 2022). When you ask patients why they do not trust their providers, they respond: “They don’t spend enough time with me “(25%), “They do not know me” (14%), and “They don’t listen to me” (14%). Others point to concerns that providers are more interested in making money than in the interests of their patients (Harris, 2022).
We all need to know that those providing care are competent and that their advice and work is directly tied to our interest. There is also a growing gap between what providers know and what patients understand. The trust that patients have in their provider bridges that gap, allowing the patient to follow the guidance of a trusted expert. In contrast, lack of trust is associated with lower rates of following providers advice, and poor use of healthcare and poor clinical outcomes (Birkhäuer et al., 2017).
Among the national efforts to rebuild trust, we should consider the strategic role of Peer Support Specialists.
Peer Support Specialists are ideally positioned to help enhance the trust people have in their providers and healthcare organizations because:
· They have personal experience as a patient and their role requires that they talk about their experience with clients.
· Because of that experience, clients tend to give them the benefit of the doubt when it comes to trust, at least initially. Over time, Peer Support Specialists have to earn their trust just like everyone else.
· They are partners with the clinicians – they may have time to spend with clients that clinicians may have difficulty finding.
· Their presence in healthcare settings is a message to clients that the providers recognize the importance of their client’s experience and
perspective.
· They represent success. They have recovered and so they are a concrete reminder that people do use healthcare successfully to recover.
Peer Support Specialists will want to think carefully about how they can help address distrust among some clients. Strategies to consider include:
1. Be reliable. I was in the audience when a congressional aide received a lifetime award for being helpful to his constituents. I can’t remember the aide’s name but I remember what they told us: “Everyday you have to do four things for your constituents: (1) Show up, (2) Listen up, (3) Speak up, and (4) Follow up”. They said that simple formula governed their career and was the reason they were helpful and people trusted them.
2. Be warm, friendly and respectful in large and small ways. A research study randomly assigned students in an elementary school classroom to either treatment as usual or to prescribed greetings. For the students in the “greetings” group, the teacher would meet them at the door of the classroom each day, say good morning to them by name, give a warm expression with good eye contact, and make a simple personal comment like “I like your shoes today!”. This took just a few seconds per student. The study found that when given those greetings, those students started to work harder and performed better in the classroom. Little signs of respect and caring have a big impact.
3. Consider how you may be the face of the clinical team/organization for some clients. People draw conclusions about organizations based on the representatives they know. They don’t need to know everyone in an organization to know if they trust it. If they trust someone and that person knows other people and helps coordinate efforts, that trust often generalizes to the whole organization. Peer Support Specialists often play that role of helping clients in a way that makes them the trusted face of the clinical team.
4. See the person. Clinical work has become increasingly technical and clinicians spend a lot of time in technical tasks. At the same time, healthcare is and will always be a deeply personal and social activity. People want to know that they are known and listened to. Peer Support Specialists are well positioned to help people feel known and heard.
5. Talk about what the client wants – do that early and repeatedly. One of the largest concerns is that clients feel that their interests are lost in the complexity of healthcare. The healthcare doesn’t make any sense if it is not keenly focused on what the client wants. Make sure they see that you are very aware of this.
6. Speak about the caring and respect of the other team members. Think about how to portray your co-workers and their feelings about the clients and the work. We know from research that people are always creating stories in order to understand their world. They are creating stories about your organization and the healthcare providers, and their behavior will be determined by those stories. Recognizing that, you want to help ensure their stories are accurate and that they include the caring and trust of the clinical team and its members. Peer Specialists can have a powerful role in influencing how clients see other providers.
7. Develop your role as an advocate. The system relies on advocates to ensure people get what they need. Clients often don’t have enough knowledge to advocate for themselves. Peer Support Specialists have an advocacy role. You know the clients and the providers and can help clients ask for what they need. You can also help providers understand what clients want.
The solution to rebuilding trust in our healthcare systems and providers will take many different steps. Given their position, Peer Support Specialists can play a key role in this effort.
REFERENCES
Birkhäuer, J., Gaab, J., Kossowsky, J., Hasler, S., Krummenacher, P., Werner, C., & Gerger, H. (2017). Trust in the health care professional and health outcome: A meta-analysis. PloS one, 12(2), e0170988.
Harris Insights and Analytics, LLC (2022). The Harris Poll: 2022 Health Information Trends.https://theharrispoll.com/wp-content/uploads/2022/07/FiercePharma-2022-Healthcare-Sources-and-Trust.pdf.
Isaacs, R.S. (2022). Five steps to restore trust in U.S. healthcare. Harvard Business Review. https://hbr.org/2022/09/5-steps-to-restore-trust-in-U-S-health-care.
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