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Healthcare has always run on trust.

Patients trust that clinicians are acting in their best interest. Clinicians trust that the system will provide the resources and support that allow them to provide good care. Society trusts that healthcare advice is grounded in evidence rather than financial incentives.

Lately, though, it feels like that foundation is shakier than ever.

I’ve been feeling this way for a long time, but I believe that we have officially hit what I'm calling the Mistrust Trifecta in healthcare — three converging forces that have systematically eroded the public's trust in the entire system.

Force #1: The commercialization of health products

Healthcare is increasingly being packaged like any other consumer product.

Direct-to-consumer drug advertising has been legal in the U.S. since 1997, and we've had almost three decades to watch it reshape how patients think about their own care. People ask for medications by name — not because their provider recommended them, but because they saw a commercial about it. Meanwhile, the pharmacy counter now competes with Instagram storefronts and a $4.5 trillion global wellness industry selling everything from "hormone-balancing" gummies to "gut-healing" protocols with zero regulatory oversight or real accountability.

If patients want a diagnosis? Download an app.

Want treatment? Click a button.

Need a second opinion? Ask an AI chatbot.

Some of these innovations are genuinely exciting. Obviously I think so. I’ve been working in this space for a decade. Well thought-out healthcare products can improve access, reduce friction, and help people get care faster.

But consumer tech products are optimized for convenience and growth. Healthcare relies on nuance. Which is why this in between space of health tech is complicated and needs clinical voices and expertise.

The danger isn't that these products exist. The danger is that patients may not always understand the difference between a tool designed to support care and one designed primarily to acquire customers or create a delightful experience at the risk of being inaccurate.

Force #2: The collapse of institutional trust

Big Pharma has spent decades earning its reputation problem and the pandemic did something that took years of goodwill and compressed it into a two-year trust collapse. Couple that with some questionable political decisions and what have you got? A significant portion of the population is now skeptical not just of drug companies, but of regulatory agencies, hospital systems, and yes — individual clinicians. You may know exactly what you're doing, but you're operating under an institutional umbrella that many patients no longer fully trust.

This is the part that stings most for clinicians who went into this work to genuinely help people.

Then top all of that off with a lack of clinician trust in the system as burnout is rampant, understaffing is common, and an overall obsession with productivity over patient outcomes.

Force #3: The rising impact of social media

Then somewhere along the way stepped in a new kind of authority figure: the wellness influencer.

They're articulate. They're relatable. They share their personal health journey. And they offer simple answers to complex problems.

The problem is that "sounds trustworthy" and "is trustworthy" are not the same thing. When someone with 800,000 followers tells their audience that seed oils cause cancer, or that raw milk is safer than pasteurized, or that sunscreen causes the health problems it's meant to prevent, many people believe them.

None of these three forces would be nearly as powerful in isolation. What's turned the mistrust trifecta into a genuine crisis is the infrastructure amplifying it: a growing percentage of the population turning to social media for their news and information paired with algorithms built to reward engagement, not accuracy.

Outrage and fear get clicks. Contrarian health takes go viral.

The algorithm doesn't care if the health content is accurate. It cares if you watched it all the way through. And the wellness influencer who says something provocative will often outperform the clinician who gives a careful, evidence-based answer.

So how do we actually rebuild trust?

Here's where I think the real work starts, but I can’t pretend to have all the answers. I’d love to hear from you if you have more ideas. I understand that if I were still working clinically, that this trust repair is literally happening everyday, in every conversation, in every interaction. Here’s just what is top of mind as I sit on the nonclinical side of the world:

1. Clinicians can show up where the mistrust is being built. The wellness influencer isn't winning because they're smarter than clinicians. They're winning because they're present — on Instagram, on TikTok, in the comments section, answering questions in real time. If credible clinical voices stay only in traditional settings, the platforms where trust is actually being won or lost will keep belonging to whoever shows up. No, this doesn’t mean that being a healthcare professional means you have to become an influencer, but if you feel so compelled to create content or contribute to publications with your ideas and opinions, you’re doing the work of fighting misinformation. But there are also countless other ways of doing this as well.

2. Health tech companies should build products with clinical voices in the room from day one. A lot of digital health tools lose trust before a single patient uses them, simply because they were designed without clinical input, and patients and providers can tell. It’s funny that only a couple of years ago, this felt like an unpopular opinion and now it’s become the norm yet some companies still get this wrong, so I will keep mentioning it until it doesn’t need to be said anymore.

3. Stay informed and aware. No matter your practice setting, it’s important to stay aware of what’s changing in healthcare, from regulations to techological advancements.

None of this is a quick fix. But it does mean the fix isn't out of reach and it isn't something only institutions can do. It's something individual clinicians and builders can start doing right now.

And if you're a clinician interested in health tech — in building products, creating workflows, and designing systems — you are in a unique spot to make big impact in this moment.

Technology may be partially responsible for the trust crisis that we’re seeing, but I’m optimistic that technology can also (when used to free up humans to do show empathy, build relationships, and think critically) help us find a path to the other side of this.

Have you felt this shift in your own practice — patients who are harder to reach, less trusting, or coming in with more "research" than ever before? I'd love to hear how you're navigating it.

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Until next time,

Lauren

The Hey Health Tech Community is where clinicians like you come to learn, connect, and finally feel less alone in this journey — without going back to school or struggling to keep up with the headlines. And now membership is available on a monthly basis.

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