Author: Building Trust

Untangling the Historical Threads of Medical Debt

Posted May 09, 2024

While more than 90% of the US population is covered by some form of health insurance, medical debt remains a persistent problem. For families with limited wealth, even a small unexpected medical expense can quickly become financially overwhelming. The evolution of medical debt into a multibillion-dollar industry raises critical questions: When and why did this transformation occur, and how has it impacted the once sacred clinician-patient relationship?

This conversation will transcend the immediate financial strain that medical debt imposes on families, delving into historical perspectives, examining aggressive debt collection tactics, and exploring medical debt’s impact on the erosion of trust within the healthcare system. 

Rebuilding Trustworthiness in Health Care

Posted May 09, 2024

Trust at multiple levels – between patients and clinicians, between those within a system that must collaborate to create high-quality care, and between communities and their health care institutions and systems – is essential for optimal functioning of the health care system. But, over the past 50+ years, this trust has measurably declined.

In response, the ABIM Foundation partnered with the Institute for Healthcare Improvement (IHI) to lead an initiative aimed at understanding and enhancing trust within health care systems. In 2022, this partnership embarked on a journey to develop a theory of change and intervention strategies to bolster trust, and in 2023, six health care systems from across the US piloted these strategies, focusing on acknowledging historical harms, addressing current trust gaps, and implementing systemic improvements.

Building Trust Through Meaningful Community Engagement

Posted March 28, 2024

Margaret Flinter, APRN, PhD, FAAN, FAANP, senior vice president and clinical director of the Moses Weitzman Health System and its Community Health Center, Inc., Nancy Oriol, MD, faculty associate dean for community engagement in medical education at Harvard Medical School, and Harvard Medical School students Tyler LeComer and William Zhuo-Ming Li, spoke about how mobile health clinics, like The Family Van, are addressing the challenge of providing high-quality, accessible health care while also fostering invaluable community engagement.

Navigating trust, safety, and excellence in patient care

Posted February 01, 2024

Susan Edgman-Levitan, PA, the executive director of the John D. Stoeckle Center for Primary Care Innovation at Massachusetts General Hospital, and Mike Woodruff, MD, an emergency medicine physician and senior medical advisor for Fidelum Health, discussed strategies to support team member safety and well-being, and offered insights on how to collaboratively enhance the overall quality of patient care and elevate the patient experience.

Eliminating medical debt to build trust

Posted December 01, 2023

Ruth Landé and Noam Levey shared their experiences and insights with Richard Baron, MD regarding medical debt, highlighting the widespread nature of the problem and its effects on individuals and communities.

They also emphasized the need for policy changes and better communication between health care providers and patients to address this issue.


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Rebuilding a foundation of trust

Posted October 26, 2023

The COVID-19 pandemic brought unprecedented challenges to the US health care system that created ethical tensions among clinicians, leaders, health care organizations, and the public. Those tensions ultimately resulted in broken trust – a foundation for ethical practice – across the system, and symptoms of moral suffering, burnout, workplace violence, and alarming shortages of health care workers.

This conversation explored the complexities of health care in the aftermath of the pandemic, its effects on communities and the people delivering care, and provided a roadmap for health care leaders to restore a foundation of trust.


Cynda H. Rushton, PHD, MSN, BSN, RN, is the Anne and George L. Bunting Professor of Clinical Ethics at the Johns Hopkins Berman Institute of Bioethics and the School of Nursing, and co-chairs the Johns Hopkins Hospital’s Ethics Committee and Consultation Service. A founding member of the Berman Institute, she co-led the first National Nursing Ethics Summit that produced a Blueprint for 21st Century Nursing Ethics. In 2016, she co-led a national collaborative State of the Science Initiative: Transforming Moral Distress into Moral Resilience in Nursing and co-chaired the American Nurses Association professional issues panel that created A Call to Action: Exploring Moral Resilience Toward a Culture of Ethical Practice.

Cynda is the chief synergy strategist for Maryland’s R3 Resilient Nurses Initiative, a statewide initiative to build resilience and ethical practice in nursing students and novice nurses. She is co-creator of the Mindful Ethical Practice and Resilience Academy (MEPRA). She serves on the Nursing Advisory Board for Corporate Counseling Associates. Cynda is a Hastings Center Fellow, Past-Chair of the Hastings Center Fellows Council, and Trustee Emeritus and a Fellow of the American Academy of Nursing. The recipient of many awards, she received the Marguerite Rodgers Kinney Distinguished Career Award and the Distinguished Researcher award from American Association of Critical Care Nurses. She is the editor and author of Moral Resilience: Transforming Moral Suffering in Healthcare and co-creator of the Rushton Moral Resilience Scale (RMRS).

Jessica Perlo, MPH, is the Executive Vice President of the ABIM Foundation, a nonprofit focused on advancing medical professionalism and clinician leadership to improve the health care system. Jessica is an expert in workforce well-being, quality, and safety and teaches and coaches around the globe, building individual and organizational capability for improvement and well-being, and has authored publications on these topics.

Building trust for healthier lives

Posted October 03, 2023

From its start in 2014 to its completion in 2020, the 100 Million Healthier Lives (100MLives) global movement fundamentally transformed the way the world thinks and acts about health, well-being, and equity. Grounded in trust, and interconnected in partnership at every level, the initiative explored the relationship between the social determinants of health and well-being and revolutionized how the public health sector works together to scale and sustain equitable outcomes. 

Drawing on the lessons learned from 100MLives, this conversation explores the power of trust in fostering collaborations among different stakeholders and outside of conventional siloes, how to contribute to a positive culture of health, and the ways in which organizations can foster a culture of well-being.   


Somava Saha, MD, MS, is President and CEO of WE in the World, and Executive Lead of the Well Being In the Nation (WIN) Network. Dr. Saha has dedicated her career to improving health, well-being, and equity through the development of thriving people, organizations and communities. She has worked as a primary care internist and pediatrician in the safety net and a global public health practitioner for over 20 years. While difficult, she has witnessed and demonstrated sustainable transformation in human and community flourishing around the world. As Vice President at the Institute for Healthcare Improvement, Dr. Saha founded and led the 100 Million Healthier Lives (100MLives) initiative, which brought together 1850+ partners in 30+ countries reaching more than 500 million people to improve health, wellbeing and equity. She and her team at WE in the World continue to advance and scale the frameworks, tools, and outcomes from this initiative as a core implementation partner in 100MLives.  

Jessica Perlo, MPH is the Executive Vice President of the ABIM Foundation, a nonprofit focused on advancing medical professionalism and clinician leadership to improve the health care system. Jessica is an expert in workforce well-being, quality, and safety and teaches and coaches around the globe, building individual and organizational capability for improvement and well-being, and has authored publications on these topics.

Building organizational trust in health care

Posted June 20, 2023

Over the past 50 years, trust in the health care sector has measurably declined, particularly in communities of color. But trust between patients and clinicians, between clinicians and the health care organizations where they work, and between communities and their health care organizations is essential for optimal health.

This conversation explored a blueprint for how health care organizations can build and strengthen trust, including acknowledging historical harms.

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The overlooked role of physician trust in patients

Posted May 24, 2023

Most of the existing literature on trust between patients and clinicians focuses on whether patients trust their care team – but what happens when clinicians don’t trust patients? Diminished relationships, less-than-ideal care, and professional burnout are just a few implications of these scenarios. And although there are differential power dynamics, the nature of trust in the patient-clinician relationship is reciprocal. Each version of trust informs the other, and both are necessary for a successful partnership.

This conversation with Rachel Grob, MA, PhD, and Tara Montgomery explored different facets of the patient-clinician relationship and possible approaches to build trust to improve quality and safety of care, patient health outcomes, and the overall patient experience.


Rachel Grob, MA, PhD, directs the Qualitative and Health Experiences Research (Q-HER) lab in the University of Wisconsin’s Department of Family Medicine and Community Health and in association with its Center for Patient Partnerships. She is also Chair Emeritus of the US Health Experiences Research Network, and Chair of DIPEx International. She is a sociologist whose career, both inside and outside academia, has been devoted to involving patients in the discourse, policy processes and institutional arrangements that impact their health care. Rachel has conducted research about patients’ experiences on a wide array of topics, her work has been supported by numerous funders including Robert Wood Johnson, the National Cancer Institute, and AHRQ.

Tara Montgomery is an EMCC-accredited executive coach and founder of Civic Health Partners, an independent consulting practice that works with purpose-driven organizations to develop trustworthy public engagement strategies and leadership practices. Her academic research on the role of trust in the US leadership response to COVID-19 informs her approach to galvanizing more trustworthy systems leaders. Tara previously spent 14 years with Consumer Reports, where she championed patient advocacy and public education campaigns and partnered with the ABIM Foundation on the launch of Choosing Wisely. Tara serves on the Board of Directors of the American Board of Medical Specialties. She is an Executive in Residence at the Saïd Business School at the University of Oxford, where she collaborates with the Skoll Centre for Social Entrepreneurship, facilitates workshops for MBA students on impact leadership, and contributes practitioner insights to graduate and executive programs in healthcare leadership.

Advancing health equity and trust in health care

Posted April 24, 2023

Organizations that directly face health equity as an explicit goal are on the critical path toward demonstrating trustworthiness to the communities they serve, but only a few have made the commitment.

This conversation explores a roadmap that health care organizations should take to build trust and improve equity in health care. Speakers share examples of specific, measurable actions and policies that organizations are currently undertaking to dismantle bias and discrimination in health care and provide guidance for undertaking this work at your institution.


Sachin (pronounced SUCH-in) H. Jain, MD, MBA, is CEO of SCAN Group and SCAN Health Plan, one of the nation’s largest not-for-profit Medicare Advantage plans, which serves more than 285,000 members across California, Nevada, Arizona and Texas. From 2015-2020, Dr. Jain was President and CEO of CareMore Health and Aspire Health, innovative care delivery systems with more than $1.6B in revenues, which serve 200,000 Medicare and Medicaid patients in 32 states. He also served as Chief Medical Information & Innovation Officer at Merck & Co. and was Senior Advisor to the Administrator of the Centers for Medicare & Medicaid Services (CMS). Dr. Jain was the first Acting Deputy Director for policy and programs at the Center for Medicare and Medicaid Innovation (CMMI). Dr. Jain graduated magna cum laude from Harvard College with a BA in government and earned his MD from Harvard Medical School and MBA from Harvard Business School. Dr. Jain is Adjunct Professor at the Stanford University School of Medicine. A widely read Forbes columnist, he has been recognized by Modern Healthcare as one of the “100 Most Influential People in US Healthcare.” LinkedIn named him its top voice for healthcare industry-related content.

Ronald Wyatt, MD, is an internationally known patient safety expert and health equity expert, and the founder and CEO of Acieving Equity LLC. Previously, Dr. Wyatt was a Vice President and Patient Safety Officer with MCIC Vermont, a major medical malpractice company. He was born in Selma, Alabama and grew up in nearby Perry County (Heiberger) Alabama. As a child, his family relied on public health clinics for practitioner in Greensboro, Alabama whose office was segregated by race. Black people were walk-in only. Prior to joining MCIC Vermont, Dr. Wyatt was Chief Quality and Patient Safety Officer at Cook County Health in Chicago and the first Patient Safety Officer at the Joint Commission. He co-chairs the Institute for Healthcare Improvement (IHI) Equity Advisory Group and is faculty for the IHI Pursuing Equity Initiative. Dr. Wyatt holds an honorary Doctor of Medical Sciences from the Morehouse School of Medicine and is a graduate of the University of Alabama Birmingham School of Medicine. He was chief resident in Internal Medicine at St. Louis University School of Medicine, where he was the first Black American Chief resident in the history of the Saint Louis University System.