It was no surprise when the Journal of the American Medical Association published research last month that found "trust in physicians and hospitals [had] decreased substantially…from 71.5% in April 2020 to 40.1% in January 2024."
The findings mirrored other recent studies that reflected the same discouraging sentiment.
This marks a sea change in the long-standing public attitude toward care providers, leaving them more vulnerable to misinformation, disinformation, and political agendas that may not serve the interests of the industry or the patients it cares for.
But there is reason for hope — and action to take.
Despite the troubling trends, America’s hospitals still wield significant political power — if they commit to the dedicated work required to use it effectively in this critical time.
In today’s political climate, the scrutiny of hospital operations — how healthcare dollars are spent, whether tax exemptions are justified, the consequences of private equity funding, and the value of consolidation — has grown in volume and intensity.
The fact is, people believe provider organizations are not focused on what they are supposed to do: take care of people. In one of our firm’s recent consumer surveys, 69% of adults said they believed hospitals, in general, are more concerned with “making money” than caring for patients, up a disturbing 16 points from just a year prior. Additionally, 64% said they support increased regulation of hospitals.
The deep-seated goodwill on which providers could once easily depend is measurably eroding. Thus, the cascade of hearings and investigations by lawmakers, regulators, academicians, and advocates continues. The hits keep on coming.
But the political vulnerability of hospitals may not be as bad as it seems.
When we surveyed the same people about the performance of “their” hospital — the one near them and where they would choose to go for care — the tables turned. A strong majority said their local hospital provides good care for their family, good value for their healthcare dollar, substantial community benefit, and is doing its part to improve access to care for those in need.
Indeed, our research shows that providers of care — hospital leaders, physicians, and nurses — remain the most trusted voices on matters not just of health, but also of health policy.
The stark difference between the public’s perception of the healthcare industry at large and their view of local caregivers reflects a simple political truism: People trust who they know.
Providers uniquely hold the political power of being present at the local level — saving lives, improving health, and serving as a community’s economic and employment engine. This distinctive advantage is important at every level of political influence.
The old saying is true: All politics is local. Perhaps a better way to put it for today is: All politics starts locally. Strong grassroots support is the currency of effective political action with local, state, and federal officeholders. It’s called “grassroots” for a reason.
This widening gap between how voters think about healthcare as a sector and the trust they have in their local providers deserves close attention.
For leaders, this work is for your executive suite, local board members, and clinical leaders. Fan out to engage community leaders, association networks, and churches. Share the story of your organization’s care, culture, and the challenges you face. Build meaningful relationships with the people you serve before you seek their support.
It’s a strategic investment of your most precious resource: time.
But is there a return on that investment? The research says yes, and it’s a large one.
For example, last month we asked 1,000 U.S. adults whether their local hospital was “providing enough community benefit” to earn their nonprofit tax exemptions. Initially, only 38% agreed that hospitals in their area were “doing enough” to justify their tax relief. In fact, 40% couldn’t name a single community benefit their hospital provided — a significant political vulnerability.
However, when we presented a list of services often categorized as community benefits by nonprofit hospitals — such as patient financial assistance, clinical research, transportation, and covering government underpayments — the numbers shifted dramatically. With just a bit of added context, 57% of respondents said their local hospitals were “providing enough community benefit to keep their tax exemption.” It’s hard to overstate the impact of a 19-point jump in support after a two-minute online interaction.
Want to influence policy in Washington, D.C.? Want to shape legislation at your state capitol? The trust-building, story-telling work starts in your primary service area — perhaps in that coffee shop a few blocks from your C-suite. You’ll find a receptive audience.
Trust in healthcare may be waning, but local providers remain deeply trustworthy. It’s an urgent, competitive edge that providers must leverage today.
Isaac Squyres is a partner at Jarrard Inc., a division of Chartis. He leads the consulting firm's issues and advocacy practice.