By Gianna Melillo
"Trust" was the word of the hour at the keynote address by Ashish K. Jha, MD, MPH, during Internal Medicine Meeting 2026.
Dr. Jha, an adjunct professor of global health at Harvard T.H. Chan School of Public Health in Boston, delivered his speech, "Clinical Leadership and Trust in the Age of Information Chaos," to an audience of rapt physicians at the Opening Ceremony on April 16.
Reflecting on the improbability of humans to thrive as a species, Dr. Jha conceded, “We are not the fastest animals on the planet. We are not the strongest. We are not the best camouflaged.” But, he said, “There is one thing that we have that most species don’t … That’s trust. We thrive as a species, we thrive as societies, because we have trust.”
Recently, though, this cohesive element integral to a functioning society has been threatened. “And that is the challenge that we face as we think about the world today,” explained Dr. Jha.
He recounted an anecdote of a patient he cared for a few years back within the Veterans Health Administration. After the patient's four-day stay, Dr. Jha recalled, the two had built a rapport and the patient was feeling great and ready to be discharged. Upon leaving the room, Dr. Jha reminded the patient to get a flu shot this year, to which he replied, “I don’t get vaccines.” The patient’s rationalization was that physicians receive financial compensation from pharmaceutical companies for each vaccine dispensed.
Instead of acting upon a reflexive defensiveness, Dr. Jha explained to the audience how he took this opportunity to learn more about the patient’s views, walking through how such a compensation would have to unfold. Ultimately the patient conceded the scheme was implausible and accepted that Dr. Jha didn’t get paid for recommending vaccines.
“So would you consider getting the flu vaccine?” Dr. Jha asked again. The patient replied, “No.”
The interaction struck Dr. Jha with a realization. “I used to have this mental model early in the pandemic that the way you communicate and the way the information ecosystem works is, as a physician, as a public health expert, I would synthesize the evidence. I would stand up on TV or wherever, and just explain what the evidence is, and people would just listen.” That model didn’t appear to hold weight anymore.
Within the past five to 10 years, the information ecosystem has become incredibly fragmented, he explained, with the information diet we all consume highly curated to each of us.
“And the challenge is that all of our information diets [are] a mix of both good information and junk information,” said Dr. Jha. Similar to junk food, if one’s entire diet becomes junk information, you get sick. This phenomenon, Dr. Jha argued, has been a major contributor to the precipitous declines in trust across institutions, including health care.
To help combat this new era, physicians ought to reflect on their own mistakes and adopt new practices and habits going forward to help rebuild that trust and improve upon it, he said.
The public health system made two glaring mistakes during the COVID-19 pandemic, during which Dr. Jha served as the White House response coordinator. “Too often, we expressed a level of certainty we did not have. … And the second was we did not do a good enough job of explaining to people how the scientific process works,” he said.
In the wake of the pandemic, calls came for better communication from the scientific community. But for Dr. Jha, better messaging can only go so far. “I don't think the problem is that we have not crafted the right set of words,” he said. Instead, what physicians need to prioritize is listening not to persuade patients, but to understand their world view. On top of that, they should lead with authenticity, he said.
While citing data may have been enough in the past, it’s more apparent than ever that this strategy falls flat in the current era, Dr. Jha explained.
“Information used to be power. One of the things that physicians had that no one else had was access to medical information,” he said. Now, information is ubiquitous. “It's everywhere. You can find anything, anywhere, at any time. Information is no longer power. Authenticity is power. Trust is power,” he said.
In clinical practice, physicians should strive to explain to patients their personal medical decisions, such as to vaccinate their own children, Dr. Jha suggested. This reminds people what you’re saying isn’t about generic advice; “this is about how we live our own lives,” he said. Partnering with already trusted members of the community can go a long way too.
One other ray of hope is that individual physicians are still largely trusted by their patients. “We have to lean into that,” said Dr. Jha.
Building back that trust and combating the fragmented information ecosystem can’t be achieved overnight, he stressed, adding that returning to a bygone era of a media monoculture also isn’t the solution.
“The world has changed in terms of how information is conveyed and understood, and we are not going back to a time period where everybody watched Walter Cronkite at the end of the day and he said, ‘Well, that's the way it is., and everybody said, ‘OK, that's the way it is.’”
Moving forward, trust, authenticity, and relationships will be what buoys physicians and the health care system at large. “The entire enterprise of American medicine rests on the belief that evidence and science, when translated through a humanistic lens, is how we make people healthier and better, and that requires all of us working together,” Dr. Jha concluded. ■