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People’s (mis)trust of doctors can help us understand their (mis)trust of journalists

Public trust in U.S. institutions has fallen to disconcertingly low levels. Journalists, doctors, scientists, and academics — once perceived as professionals with valuable training and skills who had the public’s best interest in mind — now tend to be seen as disconnected and politically compromised elites.

The crisis of public trust raises important questions. Why has public trust in social institutions fallen so much? What are the variables that determine the extent to which members of the public trust these institutions in the first place? And, finally, what steps should be taken by social institutions to repair their relationship with the public?

As journalism scholars interested in understanding how journalists and members of the public think about and interact with one another, these questions have been guiding our research for years. In our most recent effort to answer them, we conducted a research project focused on understanding how people’s distrust of journalism compares with their distrust of another institution facing a similar credibility crisis: Healthcare. The results were published last month in the communication journal Media & Communication.

Although these fields are not typically thought to have much in common, professionals within each can’t do their jobs without a trusting relationship between themselves and the people they seek to serve. We surveyed 981 members of the American public and selected 31 individuals who offered a diverse sample of adults in the United States. We then conducted in-depth interviews via Zoom to better understand their thoughts about and interactions with journalism and healthcare.

We found important similarities — and even more important differences — when it came to people’s trust in healthcare and their experiences with doctors compared to their trust in journalism and their interactions with journalists. Although people described distrusting both healthcare and journalism, individuals generally tended to place more trust in doctors than journalists. This difference was because of the public’s perception of doctors as experts in their field and the fact that members of the public engaged more frequently with individual doctors than they did with journalists.

Many respondents firmly believed that medical professionals had a specific area of expertise and, as one interviewee said, would “run tests to make sure that they’re correct” — such as diagnosing their patients via a blood test or an MRI. They perceived such test results as evidence corroborating doctors’ accurate assessments. While medical diagnostic tools served to confirm the expertise of medical professionals, the tools that journalists rely on, such as audio and video content, were considered evidence  that could easily be manipulated or taken out of context. As a result, people often engaged in their own improvised “fact-checking” of the news, seeking information from a range of additional sources to ultimately decide whether to trust a particular story. As one interviewee explained,“I just have confidence in my ability to tell what is accurate and what is not.”

Interviewees also expressed having a greater level of trust in medical professionals because of doctors’ personalized communication, which includes mentioning a patient’s medical history as well as being approachable. Even as interviewees criticized the healthcare system as a whole, they spoke positively about interactions with their primary care providers. “I felt like I was able to get everything off my chest, and I could even joke a little,” one interviewee explained about interacting with their doctor. “It felt like meeting a family member or someone I felt at ease with.”

One interesting aspect of our findings was that people were often clear about distinguishing between the healthcare system, which they tended to describe with disdain, and their individual doctor, who they tended to describe affectionately. One interviewee mentioned that finding an appointment with their physician was a challenge “and that it just became very frustrating.” But in the next breath that person said, “But I like my primary care doctor.”

There was no equivalent distinction made in journalism. People who described their irritation with the news did not go on to distinguish between the news industry as a whole and the individual journalist with whom they had an established relationship. The exception to this was people’s affection for television news anchors, especially when those anchors let down their guard a bit by, for example, apologizing on air for reporting errors. “An apology from a sincere anchor goes a long way,” one interviewee explained, “If you identify or feel close somehow to the anchor and they make a sincere apology, you want to accept it because you realize that’s a hard thing to do.”

In light of our findings, we conclude that two factors are key to building public trust: personal engagement and specialized expertise. In journalism, expertise and engagement are often presented as opposing values, with some advocating that journalists maintain a distance from the public in an effort to demonstrate their detached objectivity, while others argue that journalists should more actively engage with the public to present themselves as people worthy of their trust and support. Our research, though, suggests a different approach: Journalists should pursue engagement not as a substitute for expertise but rather as a complement to it.

Despite the nature of the news industry, which has conditioned us to believe that journalists only have parasocial relationships with their audience, recent attempts in the field suggest that closer connections can be forged successfully if journalists both share their expertise and engage with their audiences. The most common examples of this dual approach involve different forms of engagement, with journalists using social media to connect with members of the public, hold Q&A sessions and/or participate in offline events. Meanwhile, the importance of engagement reminds us to consider the issue of accessibility. People struggle to connect with their healthcare providers when they lack insurance, medical care, or live in areas with few doctors. Similarly, in the news desert, residents may struggle to find the opportunity to engage with local journalists, which makes it difficult to establish trust within their communities.

In short, to encourage public trust, journalists must find ways to demonstrate that their expertise is legitimate and trustworthy, and that means balancing that expertise with deliberate efforts to meet people where they are. Solving journalism’s credibility crisis must begin with finding ways for institutional stakeholders to meaningfully engage with the public while asserting their expertise, even at this current moment where they have increasingly limited time to do so.

Young Eun Moon is a postdoctoral researcher at the Walter Cronkite School of Journalism & Mass Communication. Kristy Roschke is a media literacy educator and scholar and managing director of the NewsCo/Lab, a Cronkite School initiative aimed at advancing media literacy via journalism, education, and technology. Jacob L. Nelson is an assistant professor at the University of Utah, and a fellow with the Tow Center for Digital Journalism at Columbia University. Seth C. Lewis is Professor, Director of Journalism, and the founding holder of the Shirley Papé Chair in Emerging Media in the School of Journalism and Communication at the University of Oregon.

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