Video Transcript: Mistrust of the Health System

Bobby Baker, PhD, Director of Faith and Community Partnerships at Methodist Le Bonheur Healthcare in Memphis, TN, USA

I did a lot of research on this for my doctoral project, and of course it just confirmed what I already knew.

Number one, there’s a history that underserved populations get taken advantage of by health care systems — when you look at the Tuskegee experiments, and there are things that are still being uncovered that the government experimented with people that were underserved. So, there’s a history of mistrust.

Secondly, if I don’t understand something, it’s difficult for me to trust it. If I don’t understand how it works. If, whenever I show up, there’s always a barrier that I can’t get around, then it feels as if the system does not want me to be a part of it, doesn’t want me to access it. So, if I’m an underserved person, and I already don’t have the resources, and I make my way to the place that I believe can help me, and I run into barriers, that certainly creates more mistrust.

Then I’d finally say this: when we think of health care and we start talking about people who are compliant and non-compliant, people who are underserved are very smart because they figure out how to live on much less than any of us could ever figure out. They figure out how to get to places they need to get to and things they need to survive, because they’re in survival mode all the time. So, one of the things that I would say to health care providers, we’d be more successful if we would stop coming up with new stuff and pave the path that some of these people are already walking.

I mean, we’ve been trying to improve [emergency department] utilization for 20 years. It seems to me it would be simple for us to look at the path people are already walking and figure out how to affect that path. We know that people are showing up at our emergency rooms and they don’t have emergencies. Now, we’ve come up with all kinds of bright ideas. How about we just pave the path they’re already walking? They’re showing up at the ED already. Why not figure out how to do something for them when they show up at the ED? Pretty simple.

That, in turn, would create trust, because I showed up where, if I don’t have any money, I know I’m going to be served. When I show up there, how about have something in place that’s going to serve me in a way that I feel that I’m affirmed and in a way that I feel that you’re not trying to get rid of me.

When we think about those things, it’s then that we can start to garner some trust in underserved communities.