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The Trust Issue

The Trust Issue

June 3, 2024

June 3, 2024

By Matt Rosenberg, MD, Chief Medical Officer, Clinical Strategy and Quality

By Matt Rosenberg, MD, Chief Medical Officer, Clinical Strategy and Quality


Matt Rosenberg, MD, reflects on an “aha moment” that shaped his understanding of patient trust.

The evening went just as planned.  

  • I made reservations at my favorite restaurant in Ann Arbor.  

  • I took myself off call for the first time in months.  

  • I had a ring in my pocket and my future wife was on a plane to meet me.

She said yes.

Then I was awakened by the kind of phone call I was trying hard to avoid. But it's a phone call that — 25 years later — I can confidently say changed my approach to being a primary care physician. 

A hospitalized patient of mine needed to be intubated. The family was worried. And they were refusing to allow intubation until they saw me.  

They needed a friendly face.  

But man, this was a bad time. 

I told the nurse she must be confused. I wasn’t on call.  

She knew that. But this patient was going to die if he wasn’t intubated.  

Walking into the ICU, I saw fear in the eyes of this family. Instantly, I knew why I was there. 

This patient and his family trusted me — probably more than they realized before this life-and-death moment. And they needed my blessing, my assurance, my compassion. 

I probably talked to them for less than two minutes and went home. As I walked back to my car, I was hit with a myriad of emotions. The first was guilt. I kinda felt like a jerk for going in so grumpy. 

Getting out of bed may have been an inconvenience, but it was, in fact, life saving for them.  

When caring is your calling card, convenience takes a back seat. 

I think back often on that night 25 years ago. I know it’s been 25 years because Stephanie and I just celebrated our 25th anniversary.  

Our jobs are hard, exhausting, frustrating. And I wouldn’t trade it for anything.  

Being one of the most trusted people in a patient’s life is incredibly rewarding — even when we’re too tired to notice 

What They Get Wrong 

The country's retail giants have been investing heavily in value-based primary care and then running into some serious trouble.

I think I know why.  

They're offering what amounts to fast-food primary care with little appreciation for the sacred bond between doctor and patient. 

Patients aren’t a commodity. The valuable commodity in our line of work is patient trust. And if patients feel as if they’re being traded like penny stocks, they will not be our patients anymore. 

When I signed on with my practice in Jackson, Michigan, the founding doctor said he would make introductions. But ultimately, he said, it was up to me to gain the trust of patients. He couldn’t guarantee they’d stick around. 

It takes work. It takes time. It takes showing we care. 

It’s not so different from trusting your mechanic or plumber. There’s comfort in having an expert to text when the wheels fall off or the proverbial poop hits the fan.  

A Transfer of Trust 

Wellvana reveres this trust patients put in their PCP. It’s why we work hard to have physicians and their staffs offer their endorsement of any interaction we have with patients — from sending them letters to remind them about their Medicare Annual Wellness Visit to our nurses who provide regular check-ins with patients who have multiple chronic conditions.

A doctor's words are powerful.  

Wellvana Care Manager Vivian Hardison, RN, provides remote care to several polychronic patients for a partner practice in Nashville. It’s so evident that the doctor is prepping patients to expect a call from Vivian.  

When she calls, they can get straight to to work checking on symptoms or reviewing medication compliance rather than Vivian having to prove it’s not a scam. 

Vivian sees her job as mostly helping patients communicate with their doctors — and sometimes vice versa. It makes a measurable difference.

Patients who have this kind of support from Wellvana are seeing avoidable hospitalizations drop 22%.  

As we continue nurturing this doctor-patient bond, we think we can do even better.