by: Sandy Marshall

Meet Simon and Ian. They met when they were ~5 months old and over the following months, a friendship grew. They played, read, ate, laughed, giggled, and cried together. They learned to trust, connect, be gentle, and share with each other–all before knowing how to talk.

Trust is the piece that I envy and admire most. Trusting someone with whom you’ve never spoken. And, more impressively, earning their trust.

Science communication is starving for trust. Rival researchers competing for the next publication. Patients asking for 2nd, 3rd, and 4th opinions from health care practitioners. Health care practitioners doubting information from patients and their families.

Fritz and Holton published an article last month, called, “Too much medicine: not enough trust?”1 Tests are being ordered with increasing frequency and the threshold for treatment has lowered.2-4 Fritz and Holton propose that a lack of trust between patients and physicians has led to excess tests and treatment. They point out that ordering extra tests or prescribing extra treatments as a way to build a patient’s trust may have the opposite effect,

“The potential secondary gain of building trust for future encounters is undermined by the dishonesty which accompanies this motive: it is not trustworthy behaviour to manipulate a patient into trusting you by preforming an unnecessary test.”1

I wonder, at what age do we forget how to connect and engage with one another? Does language actually make it harder to be honest and open? Most importantly, how do we build trust?

Fritz and Holton offer continuity and questioning as solutions. Trust builds over time, so continuity of care is crucial. Welcoming questions and acknowledging uncertainty may help, too. Excellent recommendations, but these strategies still sound a bit like chess moves.

In Alan Alda’s book, “If I understood you, would I have this look on my face?”5 he emphasizes that empathy is the key to effective communication. Once we are able to understand how someone else may be feeling and thinking, we can explain what we are passionate about in a way that they will understand and may even trust.

Thinking back to Simon and Ian, I wonder, what if we brought all of the parts of engaging to the table, with the words. What if the next scientific conference you attended was full of eye contact, sharing, and giggles? What if the next medical appointment that you had was jammed with gentleness, patience, and teamwork? Notice your whole body–eyes, hands, gestures, toe-tapping–the next time you communicate science.

Through connecting we might find clarity.


  1. Fritz Z, Holton R. Too much medicine: not enough trust? J Med Ethics. 2018.
  2. Alsan M, Morden NE, Gottlieb JD, Zhou W, Skinner J. Antibiotic Use in Cold and Flu Season and Prescribing Quality: A Retrospective Cohort Study. Med Care. 2015;53(12):1066-1071.
  3. Hensher M, Tisdell J, Zimitat C. “Too much medicine”: Insights and explanations from economic theory and research. Soc Sci Med. 2017;176:77-84.
  4. Klang E, Beytelman A, Greenberg D, et al. Overuse of Head CT Examinations for the Investigation of Minor Head Trauma: Analysis of Contributing Factors. J Am Coll Radiol. 2017;14(2):171-176.
  5. Alda A. If I Understood You, Would I Have This Look on My Face? (ed First). United States: Random House; 2017.

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