How to bring trust back into the patient-physician relationship


Health care’s journey into the digital era hasn’t always been smooth sailing. While the rapid proliferation of digital health tools has produced some major benefits both inside and outside the clinic, these technologies have also created a number of new challenges across the care continuum.

From learning new workflows to wrestling with data access and integrity concerns, clinicians are practicing in a world that looks very different from just a mere decade ago. Nothing is immune to these changes, not even the heart of the art of medicine itself: the patient-physician relationship.

In fact, that’s one of the things most affected by the digital health revolution. The focus on “disruption” in the digital health marketplace hasn’t been uniformly positive. While there are plenty of aspects of health care in desperate need of a refresh, unchecked disruption can also create a major disconnect between the people who need to work together the closest — the patient and physician.

Much of the digital health ecosystem is designed to educate and empower patients to take more control of their own health, which is an important goal for the nation’s health system. But when used in isolation without the backing of a trusted relationship between patient and provider, these tools (while well intentioned) could end up leading us down a very different path — one that brings few benefits to patients, physicians, and the health system as a whole.

Are we headed for the wrong type of disruption?

Misinformation and incorrect usage of digital tools, including patient-facing apps and devices, can erode trust and create problematic divisions between a patient and their care team.

Some patients may be a little too willing to believe everything they see on the internet and prefer to rely on influencers (looking at you, TikTok!) instead of providers when choosing digital tools and making decisions about their health. This can be extremely frustrating to clinicians who have spent their entire careers immersed in the science of evidence-based care only to find themselves replaced by social media “stars.”

At the same time, physicians who are time constrained and overburdened may not always be equipped to share the type of meaningful guidance they went to medical school to provide in the first place.

Too often, physicians are simply unable to stay up to date on the latest apps, devices, and emerging medical trends because so many of them are flooding the market. Unfortunately, many digital interventions are also deployed to the public without the data and rigor needed to ensure efficacy. Making matters more complicated, clinicians can’t always access, analyze, and synthesize data from patient-facing apps, creating friction when patients assume their providers know all about their latest health trends. And being forced to move on to a new patient every 10 minutes leaves little space for personalized, in-depth conversations about how to use digital health correctly as a part of effective self-care.

Technology developers bear some responsibility, too. Smartphone apps and home-based devices are a lucrative line of business, and regulators haven’t yet caught up to the market’s explosive growth. Patients have immediate access to millions of apps that aren’t always based on validated science and home-based monitoring devices that aren’t FDA cleared or don’t work as intended. Also, with the new crop of virtual health services, many patients and physicians have found a serious disconnect between long-term primary care teams and the often shorter-term virtual care teams.

The result is a scattered, fragmented environment where patients and providers end up at odds with one another. This misalignment naturally leads to the dissolution of trust between two parties who each feel like they’re in this alone.

We need new solutions to create resilient connections and rebuild the trust between physicians and their patients. With new strategies for maximizing the real, demonstrable value of digital health, we can shrink this divide and help reunite patients and providers in a trusted, symbiotic relationship.

Getting the industry back on track with digital health tools

To close the gaps and achieve better outcomes for everyone, all stakeholders will need to commit to open, proactive, and judgment-free collaboration.

We can start by encouraging professional societies, nonprofit conveners, and industry alliances to take a more central role in guiding the development of the digital ecosystem. For example, these groups could create registries of patient-facing devices and apps that align with evidence-based guidelines and provide trustworthy guidance to patients for specific conditions or needs.

This would give developers the guardrails they need to create satisfactory products while also giving providers a quicker and less burdensome way to stay current with the digital health market and offer high-quality recommendations to their patients. With a seal of approval from an objective party, patients can feel confident that they are using top-shelf tools that their physicians endorse, reducing the disconnect when discussing personal health tracking or other activities.

Health system leaders and health plan executives also need to take action to equip front-line clinicians with the time and resources to educate patients, answer questions, and make referrals to digital health services and other partners to help them manage their patients most effectively. These could include vetted, integrated, and targeted chronic care management programs that can spread the load for clinicians and ensure that patients are getting all the support they need in a flexible, digitally enabled manner.

By realigning the industry and patients around shared goals and expectations for digital health, we can still disrupt a status quo that needs some shaking up — but do it in a way that supports patients and providers instead of pitting them against one another. Bringing trust and connection back to the center of the patient-provider relationship will help everyone get the most out of the apps, devices, shared insights, and resources that hold much promise for better experiences and outcomes.

Arti Masturzo is an internal medicine physician and health care executive.



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