Among healthcare professionals, one of the greatest signs of trust is to have a family member cared for by one’s colleagues and the hospital where one works. Because I have immense trust and respect for my colleagues at UC Davis Health and for the work that we all do here – including in our laboratory — my husband had surgery here at UC Davis Medical Center last month. In fact, my family and I have all received our care here. We have always had an excellent experience as patients and have always received outstanding care, reinforcing our trust in the institution, the faculty and staff here, and our belief in the values that we mutually share regarding caring for others.
I was therefore surprised to learn recently that there is a decline in trust in America — in fact, trust is declining world-wide. Edelman, a global communications firm, does an annual “trust barometer” and their findings were shared at Council of Chairs not too long ago (1). In the US, the general population’s average trust declined by 9% — the steepest decline ever measured. And the trust index among the “informed” US public declined 23 points, making our country similar to the level of trust in South Africa, Russia, and Poland. The media emerged as one of the least trusted industries, affecting trust in others. Fifty-nine percent of respondents in the Edelman survey said that they “don’t know what is true or not”, 56% say they “don’t know what politicians to trust, and 42% say they don’t know what companies or brands to trust (1).
Health care has not been exempt from this decline in trust. Research on Harris polling data published in the Journal of the American Medical Association demonstrated that that only 34% of the American population reported “great trust” in leaders of the medical profession in 2012, a decline from 73% in 1966 (2). Interestingly, the US ranks third in the world for the proportion of adults who are satisfied with the quality of the treatment they have received (2). This says to me that trust can be earned, especially on an inter-personal level in the provision of care.
In my opinion, our roles as laboratory professionals, pathologists, and biomedical scientists are all essential to ensuring the public’s trust and satisfaction with health care. In fact, I find it inspiring that technical and academic experts (ie., us!) are ranked as the most credible in the Edelman survey (1). Trust is linked to uncertainty and to navigating the possibility of high-stakes outcomes (3). As members of a prestigious academic health center and university, we create trust — we ensure an accurate and high-quality result based on sound science that minimizes risk in the high-stakes world of health care. Our role is extremely important since patients who have high trust in their health care professionals demonstrate more beneficial health behaviors, higher quality of life and greater satisfaction with treatment (4). As we love to share, 70% of all medical decisions are based on the testing we provide. Physicians will not appear confident in their decision-making if they don’t trust the laboratory. Patients cannot feel trusting toward their health care providers, if neither of them trusts their lab tests.
During the month of September, we begin the three month window for our biannual accreditation inspection from the College of American Pathologists (CAP). Maintaining this rigorous accreditation is an essential part of being trustworthy as a laboratory, and I know that our staff and faculty section directors work hard to be sure that every detail is in place for the inspection. CAP’s peer-reviewed inspection program not only meets federal regulations required by the Clinical Laboratory Improvement Act, but has an even higher bar. There are hundreds (maybe even thousands) of items on the CAP inspection checklist – these represent the most comprehensive scientifically endorsed laboratory standards and are used worldwide to ensure quality and accuracy (5).
At the white coat ceremony for our new clinical lab science and cytotechnology students just a few weeks ago, I was reminded of the special trust that the public holds for us – the white coats and the oath that our student take are both symbols of trust. I am confident that we meet this trust – and that we will shine during our inspection, just as we do all year long. I hope that all of you will join me in showing off the great work that we do when our inspectors arrive – and that you will share your pride with the inspectors, as well as with clinicians who use our services and with each other all year long. Every day of the year – inspection time or not – I am so impressed by the professionalism and dedication of our laboratory team and the very frequent extra effort and sacrifices that many members of our department make to meet the needs of our patients. I am grateful for all that you do — you have my trust and that of our patients, including the patients in my very own family.
- 2018 Edelman Trust Barometer Global Report. http://cms.edelman.com/sites/default/files/2018-02/2018_Edelman_Trust_Barometer_Global_Report_FEB.pdf
- Blendon RJ, Benson JM, Hero JO. Public trust in physicians: US medicine in international perspective. JAMA 2014; 370:1570-1571.
- Armstrong K. If you can’t beat it, join it: uncertainty and trust in medicine. Ann Intern Med 2018; 168:818-819.
- PLOS one https://journals.plos.org/ploone/article?id=10.1371/journal.pone.0170988
- Laboratory Accreditation Program, College of American Pathologists. http://www.cap.org/web/home/lab/accreditation/laboratory-accreditation-program?_afrLoop=103994775194685#!%40%40%3F_afrLoop%3D103994775194685%26_adf.ctrl-state%3D12yftltko_4