Commentary: Beyond AI: Empathy & Trust
by Tim Size
(Tim Size is executive director of Rural Wisconsin Health Cooperative, Sauk City. RWHC is owned and operated by forty-four, rural acute, general medical-surgical hospitals. The cooperative’s emphasis on developing a collaborative network among both freestanding and system affiliated rural hospitals distinguishes it from alternative approaches. In 1996, RWHC created a non-voting Affiliate Membership for specialty provider-based systems.)
In our March newsletter, we reprinted an Op Ed by Jerry Deschane, Executive Director, League of Wisconsin Municipalities, “Innovation is a People Business.” I would like to share a few thoughts triggered by reading his insightful piece. Every day we are reminded of the current new big thing–Artificial Intelligence or just plain old AI. I am working on trying to understand how AI may impact healthcare going forward and in particular its impact on the relatively fragile rural healthcare ecosystem.
AI has its own opinion: as downloaded from Gemini on 1/30/26: “AI is poised to fundamentally transform healthcare through enhanced diagnostics, automated administration, and tailoring treatment to the individual. Key impacts include accelerated drug discovery, real-time patient monitoring via wearables, and AI-powered diagnostic tools that improve accuracy. It will also reduce clinician burnout by handling documentation.”
I had to ask a second time for AI to be a bit more introspective about potential downsides. It responded: “Potential downsides to AI in healthcare include significant data privacy breaches, algorithmic biases leading to health disparities, and reduced human interaction affecting patient trust. Over-reliance on automation may degrade human judgment, while high implementation costs and unclear legal accountability for errors present major adoption hurdles.”
As we innovate with AI, what do we need to reinforce or rediscover about the role we humans play in caring for the health and wellbeing of each other? How do we continue to put first the importance of the relationships we need to have with each other and our communities?
An example of the unique good humans/people are capable of is our ability to show empathy–to understand and share the feelings of another. One of the best examples I have ever personally experienced was during an extended hospitalization several years ago following an encounter with black ice. I benefited from extraordinary technical care but the moment that I most remember was when, in response to feeling a bit down, a caregiver lightly (and appropriately) touched my arm. It was exactly “what the doctor ordered.”
I am not arguing that AI is opposed to empathy. I am expressing a concern that if we put all of our eggs (resources) into one tech basket, we risk not prioritizing time available by healthcare providers to build and sustain the relationships that are vital to our health. AI has the potential to “free up” clinician time; determining the best reuse of that time is a major challenge of the era of transformation driven by AI.
In addition to empathy and supporting patient-clinician relationships is a second major issue: the importance of maintaining and restoring trust in health care. According to the National Library of Medicine, trust in physicians and hospitals combined decreased substantially over the course of the pandemic, from 71.5% in April 2020 to 40.1% in January 2024. “Several forces lie behind this trend. The COVID-19 pandemic–marked by politicized public health measures and pervasive misinformation–fueled public skepticism. Patients also increasingly perceive the healthcare system as prioritizing self-interest over patient welfare.” (“The Erosion of Trust in Healthcare: Restoring the Patient-Physician Relationship,” Physician’s Weekly, 7/10/25)
As reported in Harvard Business Review (9/8/22), “mistrust in health care puts health and lives at risk–individuals are (1) less likely to seek healthcare, (2) less open in conversations with clinicians, and (3) less likely to comply with medical advice and prescriptions.” Unfortunately, there is substantial evidence showing that trust continues to be in decline; a decline that didn’t start with the pandemic but was significantly accelerated by it.
There are multiple strategies to increase trust that are frequently cited. They all take more time between a clinician and patient.
A few examples include:
-Communicating with clarity and empathy (avoiding jargon, listening actively and acknowledging concerns).
-Empowering patients through shared decision-making (explaining all options, respecting autonomy, collaborating on agreed to goals).
– Ensuring continuity of care (coordinating care and following up).
Showing empathy and building trust in health care needs to be deliberate and it requires an investment in time. We need to assure that clinicians’ time with patients is a priority and we don’t “throw the baby out with the bathwater,” as more call for the transformation of care in the name of efficiency.