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If Trust is the Glue of Life¹, What's Holding our Organizations Together?


According to Merriam-Webster, the primary definition of trust is, “the assured reliance on the character, ability, strength or truth of someone or something; one in which confidence is placed.” Trust is at an all-time low in our country. Events over the past few years have helped to create this decline and the trend is one all of us in health care philanthropy should be addressing, as health care is being directly impacted. A lack of trust prevents patients from seeking care and believing when they do seek care they are receiving the best possible. A lack of trust prevents people from investing in their hospitals for fear their money won’t be used wisely. A lack of trust prevents neighbors from linking arms together to support their communities and effect change for the better. Is it possible for those of us in philanthropy to combat this growing trend of distrust and move the needle to a more positive state? The answer is yes, and it starts with a core tenet of our profession: relationship building.

To build authentic relationships and address mistrust, we must first understand what the environment looks like in our country. According to Gallup, confidence in the medical system dropped six percentage points from 2021 to 2022, and another ten of the 16 institutions Gallup measured (such as military, police, church, schools, etc.) saw decreases.²

Is it possible for those of us in philanthropy to combat this growing trend of distrust and move the needle to a more positive state?

Digging down deeper into our industry of health care, a 2021 survey conducted by NORC on behalf of the American Board of Internal Medicine Foundation uncovered startling data around the communities’ overall trust of hospitals and of clinicians. The survey revealed a stronger trust held by patients for their physicians than for the hospitals where those physicians provided their treatment.³ This could be in part due to the lack of trust physicians have for hospital executives; a third of physicians do not trust their health care organization’s leadership and even fewer trust health care executives in general.⁴

Perhaps their viewpoint is trickling down to their patients in a subconscious (or conscious) manner.

Additionally, the survey reviewed perceptions physicians have about what causes mistrust in their patients contrasted with what actually causes patients to have mistrust of their physicians, as shown in the included charts.

It should be noted patients lose trust when their relational needs aren’t met by their physicians, while physicians believed mistrust occurs from more economic and pragmatic needs. Physicians responded in the survey they believed the following actions would build patient trust: listen, spend time, understand their problems, answer their questions and show empathy, but they are not always capable of performing those trust-building behaviors.⁵

In addition to the mistrust existing in the health care industry between patients, physicians and systems, it is quite alarming to also see the data about the lack of trust donors have in nonprofits in general. This trend is especially concerning in a time when we are seeing a decline in the number of donors to nonprofits. The 2022 AFP Fundraising Effectiveness Project showed a 7% decline in the number of donors from 2021 to 2022 and a 4.2% decline in the retention of donors.⁶ Knowing it is more costly to find new donors than it is to retain them, philanthropy teams must focus efforts on increasing retention.

While these statistics are alarming, they are showing a trend that can be reversed. Philanthropy teams are in a position to lead this charge. Through relationship building and the simple connection of people, passion and purpose, philanthropy leaders and donors can grow reliability, communications and trust. In Part Two of this series, we will discuss strategies to help turn this trend around.

¹ “First Things First”, Stephen R. Covey, A. Roger Merrill, Rebecca R. Merrill, 1995.

² “Confidence in U.S. Institutions Down; Average at New Low,” Jeffrey M. Jones, GALLUP, June 5, 2022.

³ “Surveys of Trust in the U.S. Health Care System,” ABIM Foundation, June 2, 2021.



AFP, Fundraising Effectiveness Project, 2022, Independent Sector, Health of the U.S. Nonprofit Sector Quarterly Review, January 10, 2023.

Accordant White Paper_Trust is the Glue of Life
Download PDF • 526KB

About the Author: Pamela Ronka Maroulis, FAHP, CFRE, is President and Principal Consultant with Accordant, specializing in building relationships and helping donors support their passions. Pam can be reached at or by connecting through LinkedIn.


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The Accordant Team has published a number of books to advance the efforts of health care philanthropy and help development leaders everywhere. 

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Accordant is honored to collaborate with American Hospital Association Trustee Services to provide issue papers, templates and webinars to support the involvement of healthcare trustees and foundation board members in advancing philanthropy. These resources can also be found on the AHA Trustee website.

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