Transparency is another cornerstone of trust. We have an obligation to go beyond and educate patients on why we recommend the treatments that we do. Explaining the rationale behind a treatment plan, acknowledging uncertainties, and discussing potential side effects in a way that is understandable to both the patient and clinician openly fosters an equitable sense of partnership.
Just as importantly, trust is built over time. In outpatient rheumatology, we have the capacity to show our dedication, time after time and visit after visit. Patients are watching for consistency of our efforts. Therefore, each follow-up visit is an opportunity to strengthen the relationship, to celebrate progress, and to navigate setbacks together. This continuity not only builds trust, but also reinforces the therapeutic alliance that is essential for managing chronic disease.
Sustaining Trust Within Communities
Clearly, individual patient-physician relationships are the building blocks of a culture of trust, but bonds must also be strengthened at the community level. Communities that trust their healthcare providers are more likely to engage in preventive care, participate in research, and adhere to public health initiatives.4 Conversely, communities where mistrust prevails are at greater risk of health disparities, vaccine hesitancy, and poor outcomes.5
As rheumatologists, we can play a role in fostering community trust by extending ourselves beyond our clinical practices. Engaging with local organizations, speaking at community events, and participating in health fairs are tangible ways to demonstrate our commitment to the well-being of the broader population. These actions humanize us as physicians, breaking down the barriers of hierarchy and formality that often distance clinicians from the communities they serve. However, for these approaches to be sustainable, there needs to be a means of reimbursing outstanding rheumatologists for their community outreach.
Representation matters, too. There remains much work to be done to ensure the rheumatology workforce is as diverse and representative as the groups we care for.6 Support for ongoing intentional efforts to recruit and mentor a diverse pipeline of rheumatologists, as well as designing studies that prioritize inclusivity, are necessary. When communities see themselves reflected in the healthcare system, there is a potential for the creation of trust.
Moreover, sustaining trust within communities requires acknowledging past wrongs conducted by the medical community and working to prevent future harm. Historical injustices, from unethical research practices to systemic discrimination, have left deep scars in many marginalized communities. As rheumatologists, we must join hands with others to advocate for equity in care delivery, transparency in research, and policies that address the root causes of health disparities. Trust is not given; it is earned through consistent, meaningful action.
