Increasing trust in health care

Trust in American health care and in the people running medical institutions is in decline, which poses a threat to the physician-patient relationship. In response, the ABIM Foundation has established the Building Trust initiative, which includes the Trust Practices Network, advancing research in trust, leadership convening, and various communications vehicles. The Trust Practices Network includes hospitals and health systems, specialty societies, health plans, consumer organizations, employers, and others who are working to reaffirm and strengthen trust as a pillar in their own missions. Participants offer examples of how they have built trust, and their contributions have illuminated 4 dimensions of trust: competency, caring, communication, and comfort. This commentary discusses an exemplary practice for each of these dimensions and describes the "positive deviance" strategy that underlies the Trust Practices Network. It also offers an overview of the other elements of Building Trust, such as a grant program to promote trust as well as diversity, equity, and inclusion in internal medicine education, and an effort to spur additional research on trust.