This essay summarizes key insights across the essays in the Hastings Center Report's special report “Time to Rebuild: Essays on Trust in Health Care and Science.” These insights concern trust and trustworthiness as distinct concepts, competence as a necessary but not sufficient input to trust, trust as a reciprocal good, trust as an interpersonal as well as structural phenomena, the ethical impermissibility of seeking to win trust without being trustworthy, building and borrowing trust as distinct strategies, and challenges to trustworthiness (...) posed by the contingent nature of science. Together, these insights stand to advance an area of research that we believe has been historically stymied by conceptual confusion and a long‐standing insistence on treating trust as a purely instrumental good. (shrink)

Prior research has documented how important it is to patients to be able to trust their physicians. In this essay, we introduce physician perspectives on the importance of earning patients’ trust. We conducted twelve semistructured interviews in late 2022, eleven with physicians and one with a patient‐experience expert. Physicians described earning patients’ trust as crucial for working effectively with patients, with several saying that it was as important as having medical knowledge. Physicians also expressed that feeling a patient trusting them (...) is professionally rewarding and fulfilling. To build trust with patients, physicians reported, they make the medical interaction all about the patient, express their belief in their patients, share their personal experiences, and use other strategies identified in previous literature: communicating effectively, being compassionate, and demonstrating competence. Physicians also reported experiencing challenges in building trust with patients, most often because of patients’ lack of trust in other levels of the health care system and because of having inadequate time to spend with patients. Additionally, Black and Brown physicians described how patients’ bias often blocks trust. (shrink)