Trust is really about relationships and it can be relationships between people it can be relationships between a person and an organization or it can even be between people and events people actually have different definitions for trust and I think it's important to think about what do we mean by trust some would call it an action based on expectations of how others will behave in relation to yourself in the future another definition of trust that applies well in the health care setting is the following the optimistic acceptance of a vulnerable situation in which the trustor believes
the trustee will care in the trusters interest there are some parts of that definition worth emphasizing in particular this notion of vulnerability that there has to be some sense of vulnerability in a trusting relationship whether it starts from that place or develops into a vulnerable place so you can imagine having a relationship with someone and once you are very trusting of that person that actually can make you more vulnerable more commonly in the health care setting though we see a patient who because of their illness has some inherent vulnerability and that helps to set up
a situation where trust can build another important piece of this definition is this concept of motivation the idea that in a trusting relationship one person is doing something caring for another person or something in another person's best interest and finally embedded within this definition is the notion that trust is a forward-looking concept well it may be influenced by past events it really describes how a person or organization behaves moving forward in talking about what trust means we also have to kind of consider what's meant by distrust and while the jury is kind of out about
a clear definition I think there's some important things to talk about some people would talk about distrust as the absence of trust the lack of familiarity sort of not having a feeling one way or another another way to look at distrust is that it's the opposite of trust that it's a situation where a person is pessimistic or concerned about another person's motivations and finally one can think about distrust as a substitute for trust not necessarily the opposite of trust so at some level you can have distrust and trust at the same time so for example
maybe I get sent to an emergency room and I feel confident about the situation because I know it's a good emergency room but something happens and I sort of feel like well I'm going to hold out and reserve judgment so you can kind of share a sense of trust and distrust simultaneously this notion about like trusting but let me make sure that's really the case when we talk about trust in healthcare I think it's important to consider it in relationship to two different groups you can have individuals and you can have systems even in this
sort of individual group you can identify differences so you can have a particular one individual a doctor or a nurse or you can have kind of an institution that's an individual institution within a larger group so maybe one hospital within a whole healthcare system and then you can also look at it from a more systems perspective and even if in that context there's sort of more individuals and then more institutional things so for example maybe the kind of group or system of how emergency doctors function or how surgeons tend to function is maybe a more
systems approach or you have how a particular institution how hospitals work it can also be a more systems based perspective the other thing to keep in mind is that relationships can be personal and they can be impersonal in the health care system so again i use the individual doctor with their patient as a very personal relationship and even patient may have a personal relationship with a hospital you can imagine having a feeling of trust for a particular hospital and in that way kind of personalizing that relationship so if we think a little bit more about
the different players in the healthcare environment how they interact with individuals and systems you can think of patients and how a patient interacts with their provider you can think of how a patient interacts with a group of clinicians and you can think of how a patient interacts with an institution a hospital and insurance company or even the sort of notion of medicine at all you may have someone who doesn't believe in Western medicine and so even this concept of Western versus non-western this system of Western medicine versus non Western medicine is important for some patients
