A New Requirement for Investigators: Empower Public Trust in Your Research.

My mother, now 90, grew up in an era where the ‘doctor knows best, but those days of assumed expertise are gone. Only 36% of U.S. adults say they have a great deal of confidence in the medical system, according to a recent Gallup poll. That figure was 80% in 1975. Science was not far behind, experiencing a dramatic erosion in public trust in the wake of the COVID-19 pandemic.

How are we going to rebuild trust with our patients? The solution can start with research. For over a century, evidence-based medicine, derived from reliable, truthful research, has improved our healthcare. Rebuilding trust in research and science can once again rebuild our trust in medicine. 

So, how do we do this? It needs to start with reframing our concept of ‘successful  research.  

Years ago, a colleague who came from the pharmaceutical industry shared with me a perspective I never considered: “You know, in the business world, when somebody says that a new idea or approach is ‘academic,’ it’s not a compliment—it’s a criticism.” He explained that “academic” work was seen as purely theoretical and disconnected from the reality of everyday business.

I was dumbfounded. In my world, academia was revered. It’s a symbol of rigor, precision, and the highest standard of care. Unfortunately, his negative perspective has grown over the years, as scientific research has increasingly been seen as out of touch. How did this happen, and what can we do to reverse the tide?

As investigators, we often measure the value of our work by the number of peer-reviewed publications in medical journals. We feel we have succeeded when our paper is published in a prestigious journal, and we are invited to present the work at a national conference. We find ourselves spending a lot of time talking ‘to each other’ and shining in the light of our colleagues’ praise. Although we may post about the research on social media or provide a link to the publication on our LinkedIn bio, we spend less time disseminating the work. Our assumption is that rigorous science will ultimately speak for itself in the public sphere. This approach can appear divorced from the broader lay community and even seem disconnected from reality (i.e., the businessman's definition of ‘academic’!). What is worse, in a world of distrust of science and medicine, our silence in the non-scientific community can be mistaken for elitism. 

If we expect people to trust and value our work, we must reframe our own definitions of success and find a new way to measure and communicate the impact of our research. 

Proposing a patient-centered impact factor.

As a clinician-investigator, my CV was a source of pride and accomplishment. I would update it every few weeks because this catalog of publications was how I defined my contributions to the field, and how I measured my value. 

Similarly, journals themselves have long measured their success by an “Impact Factor,” which counts how often their articles are cited as an indication of relevance.

The truth is, neither my CV nor a journal citation ever helped a sick patient. In a world of distrust, we must find a new way to measure our work. 

Improved health and well-being can no longer be a byproduct of research. It must be a required metric, a new impact factor. Our research goals should be creating new findings that make a difference in people’s lives. Our value should be measured not in citations but in advancing health and lives.

What are the first steps to reframe success in research? I suggest three pillars (and a bridge) that can help researchers do our part to rebuild trust in our important work.

Related: Read “Lessons in Leadership: Advice for Guiding Scientific Organizations During Times of Change.”

A framework for building trust.

To ensure our work is focused on making an impact, we should employ techniques and methods that enable us to:
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1. Ask meaningful questions: When we’re deciding what to study, we should use patient-centered criteria and stakeholder partnership to ensure we’re selecting research topics that have the potential for immediate, tangible impact on the people we serve.

2. Incorporate radical inclusion: Deep partnership with patients before, during, and after research ensures studies solve real-world problems. This requires researchers to listen and incorporate the perspectives and experiences of non-medical experts in our communities.

3. Prioritize non-scientific communication: Our outreach must move from a model of “publish and present” [at scientific meetings] to authentic public engagement. This means meeting patients in their world, online in their social communities, and speaking with them authentically in their language about how and why our research matters. It isn’t about posting a link to your paper; it’s about leveraging tools patients already use to create a continuous feedback loop.

The bridge that connects these pillars to the community is “implementation science.” By ensuring solutions work in community clinics, not just university hospitals, we’ll better understand how to advance health in our neighborhoods through impactful relationships. 

Related: Read “Rebuilding Trust in Healthcare Starts with the People and Communities We Serve.”

Science must lead the way forward.

If we’re going to fix this gap in trust, our scientific community must lead with a pragmatic, empathetic approach. 

When my colleagues ask how we can rebuild trust, I point them to our D.C. Safe Babies Safe Moms Program. The outcomes we’ve achieved (such as patients being less likely to have babies preterm or with low birthweight) happened because dedicated researchers did the difficult work of building lasting, mutually beneficial partnerships with community organizations and individuals. 

Because we took their experiences seriously and integrated them into our research. Because we communicated our results with the intention of the people who needed to hear them.

I know we can replicate this model, and I believe it’s key to bringing research back into contact with the patients who rely on our expertise. This shift is challenging. It will require us to rethink our assumptions and shake up our habits.

While publications are critical, they can no longer be the finish line for academic research. Our work should only be considered “done” when our neighbors feel better and when they know our work has helped them live their best life.