Medical Mistrust: The Social Determinant of Health We Ignore
What if the biggest driver of poor health isn’t just housing, food, or income – but mistrust? In this episode, host Judson Howe sits down with Dr. Katherine Gergen Barnett (KGB) – family physician, health policy leader, and community-based researcher at Boston Medical Center – to unpack medical mistrust as a social determinant of health and what it really takes to rebuild trust in the exam room and beyond.
Episode Summary
Medical mistrust isn't irrational — it's rational. Dr. Katherine Gergen Barnett walks through why communities that have been harmed by medical institutions continue to distrust them, and why dismissing that mistrust as a patient problem is both wrong and dangerous. She discusses the history behind mistrust (Tuskegee, forced sterilizations, the persistent pain-dismissal gap for Black patients), how she trains clinicians to recognize and respond to it, and why trust-building must be treated as a clinical intervention, not a soft skill. This is one of the most urgent conversations in American medicine.
People Mentioned
About the Guest
Dr. Katherine Gergen Barnett
Vice Chair of Research, Dept. of Family Medicine · Boston Medical Center
Dr. Katherine Gergen Barnett — known widely as KGB — is a family physician and community-based researcher at Boston Medical Center, where she serves as Vice Chair of Research in the Department of Family Medicine. She has pioneered work on medical mistrust as a social determinant of health, studying how historical betrayals by the healthcare system continue to drive disparities in treatment-seeking, adherence, and outcomes. She is a nationally recognized speaker, author, and clinician known for her warmth, candor, and fierce commitment to meeting patients where they are.