Regaining Trust: Health Care Transparency in the Age of Misinformation

Ms. Cronin is the Executive Director of the Informed Patient Institute, an organization she founded in 2007. She previously served as Director of the Center for Beneficiary Services at the Centers for Medicare and Medicaid Services and Senior Vice President for Health Pages. She chairs the Medical Board Roundtable, a project of the Patient Safety Action Network, and serves on the Johns Hopkins Hospital Patient and Family Advisory Council and Patient Safety Committee. She has been a member of the ABIM Geriatric Medicine Board since 2021.

The rise of and access to misinformation in public media is among the factors leading to more patients losing trust in physicians. Due to this and other factors like a systemic lack of transparency and the increasing role of private equity in health care, patients in the American health care system face myriad difficult decisions to make about their own care, such as who to trust with their health, what questions to ask and what constitutes a safe health care environment. And it’s all very expensive.

Adding to the confusion, what patients hear in an exam room could run counter to what they’ve read or seen online from a group or individuals they trust – even if those sources lack the same medical knowledge or credentials.

All told, the volume of misinformation or conflicting information makes it even more challenging than ever for patients to feel confident in their decisions about their own health and that of their loved ones.

As health care professionals and advocates for patients’ safety, one of the ways physicians can help address this problem is by promoting greater health care transparency about themselves and the institutions they work for, providing resources and education for patients and empowering them to make better informed decisions for themselves.

I founded the Informed Patient Institute (IPI) in 2007 to help patients track and utilize public reports about the quality, safety and other information regarding doctors, hospitals and nursing homes nationwide. IPI has also provided resources on what to do if a patient has a concern about quality. And most recently, working with others, we are focusing on how the physician community polices itself in the case of harmful physicians primarily through State Medical Boards.

The average patient—that is, the person who is not deeply embedded in health care and serious health issues—may not understand the broad range of quality differences at any level of health care, whether it’s an individual provider or an institution like a hospital or rehabilitation facility. While most people do not understand what board certification or Maintenance of Certification (MOC) entail, they do understand the concept of specialized training and the need for demonstrated continued learning in the face of ever-changing medical knowledge.

Those of us working in patient advocacy understand this and work to make it easier for patients in general to understand. When someone asks me how to find a physician, I point them to two websites: DocInfo from the Federation of State Medical Boards and CertificationMatters from the American Board of Medical Specialties. These offer unifying access to information from all of the different state medical and certifying boards, including whether a doctor is participating in MOC or its equivalent. After many years of work on quality and measurement, I wish there were more public resources that were available—particularly that focus on the outcomes of care like the Society of Thoracic Surgeons’ website on surgical outcomes: https://publicreporting.sts.org/

Through the work of the IPI and other organizations, we seek to make the right information more transparent and accessible to patients. Those of us working in patient safety know that there are enough instances of patients being harmed to raise concern when improvements take years to occur. While the vast majority of physicians are hardworking and dedicated, changing incentives in health care and the rise of misinformation make it difficult and expensive for patients and families to navigate health care today.