But what can we do beyond recognizing the problem? One approach is to have a larger interprofessional care team to help address these issues. Physical therapy and occupational therapy can be essential in helping remove social barriers associated with physical limitations. Psychologists and other mental health specialists may similarly provide tools to address mental health issues that contribute to loneliness.
Additionally, clear communication with primary care clinicians may plug people into larger networks that can address loneliness. Indeed, our geriatric colleagues have long grappled with managing patients who feel socially disconnected, and we can learn much from the interprofessional networks they have created.
Another approach is to foster community within and between our clinics. Support groups, either in person or virtual, can provide a space for patients to connect with others facing similar challenges. These groups do more than share information; they offer solidarity, validation and a sense of belonging.3 Similarly, we can encourage patients to engage in gentle physical activities as tolerated, such as yoga or water aerobics, that reinforce the link between physical health and social interaction.
On larger scales, combating loneliness requires us to look beyond the confines of our clinics. It challenges us to advocate for systemic changes that prioritize social well-being—policies that promote community building, equitable access to mental health services and the meaningful integration of social determinants of health into clinical care. In addressing loneliness, we not only improve individual outcomes, but also begin to mend the broader social fabric.
Building Trust with Patients
If loneliness is one side of the societal fragmentation coin, mistrust is the other. Nowhere is this mistrust more pronounced than in our healthcare system, where patients are often alienated by opaque systems, rushed interactions and a sense of being reduced to a collection of symptoms. For patients with rheumatic diseases, who frequently navigate complex treatment regimens and the frustrations of delayed diagnoses and treatment, building trust with their healthcare providers is simultaneously critical and challenging.
As any patient or clinician can tell you, trust begins with listening. As rheumatologists, we pride ourselves on our diagnostic acumen: It is our ability to listen deeply—to hear what is said and unsaid—that lays the foundation for our field. Not coincidentally, these foundations are also the same for the building of trust. When patients feel heard, because they are heard, they are more likely to share openly, adhere to treatment plans and collaborate in their care. This requires more than just asking questions; it demands a commitment to being fully present in the encounter, free from the unneeded distractions of ubiquitous electronic health record systems, ticking clocks, or social media.
