Building Trust in Healthcare during Turbulent Times: T.H. Seldon Memorial Lecture

Jordan Francke, MD, MPH

An electrifying plenary session, “T.H. Seldon Memorial Lecture: From Evidence to Action: Overcoming Challenges in Clinical Practice Change,” kicked off the 2026 Annual Meeting, presented by IARS and SOCCA, on Friday morning, May 1. Current IARS President and Chair of Anesthesiology at Mass General Brigham, Oluwaseun Johnson-Akeju, MD, opened the session by offering meeting participants a warm welcome to the vibrant city of Montreal, Canada. Dr. Johnson-Akeju expressed his gratitude to the many members of the IARS community that make this Annual Meeting possible including, but not limited to, the Annual Meeting Oversight Committee, IARS’s partner organization Society of Critical Care Anesthesiologists (SOCCA), and the various vendors and donors to the IARS. He also introduced the newest member of the IARS Board of Directors, Bruce Biccard, PhD, Nuffield professor of anesthetic science at the University of Oxford in the United Kingdom. He closed by introducing the incoming president of IARS, Vivianne Tawfik, MD, PhD, associate professor of Anesthesiology, Perioperative, and Pain Medicine at Stanford University.

Dr. Tawfik also expressed her warmest welcome to attendees (in both English and her native French!) before announcing a new award of the IARS: Volunteer of the Year. This award recognizes individuals who have significantly advanced the mission, programs, and global community of the IARS through exemplary volunteer service, and honors volunteers whose leadership, dedication, and passion make a lasting impact on the Society and the international anesthesia community. The inaugural recipient of this year’s award is Patrick Olomu, MD, FRCA, FMCA, division chief of Pediatric Anesthesia and professor of Anesthesiology at Virginia Commonwealth University, for his unflappable leadership and service in his role of International Subcommittee Chair. Congratulations to Dr. Olomu!

This year’s plenary session was delivered by Sharon Straus CM, MD, MSc, FRCPC, FCAHS, FRSC, professor of Medicine at the University of Toronto and executive vice president, clinical programs and chief medical officer of Unity Health Toronto. A geriatrician and clinical epidemiologist, Dr. Straus has authored more than 650 peer-reviewed publications and three textbooks in evidence-based medicine, knowledge translation, and mentorship. In her talk, entitled, “From Evidence to Action: Overcoming Challenges in Clinical Practice Change,” Dr. Straus aimed to convince the audience that science is our superpower, and one of our best defenses in the turbulent and unpredictable times the world is currently seeing.

Dr. Straus began by discussing that growth in medical distrust, misinformation, and disinformation has become nearly ubiquitous. One result of this within Canada is that the country recently lost its status as measles-free. This growing skepticism of medicine, leadership, and truth has created deep divisions both within and across countries, and the World Economic Forum labeled geoeconomic confrontation as its most severe risk to trigger material global crisis in 2026. Dr. Strauss emphasized that public trust in science and medicine is beneficial to society: it helps patients make evidence-informed decisions, it serves as the foundation for policy making and may even facilitate economic optimism.

However, the Edelman Trust Report of 2025, a survey of 16 countries, illustrated that nearly a third of respondents reported that they were just as knowledgeable as their healthcare provider and that trust in physicians is declining while trust in medical advice of friends and social media was growing. This erosion in public trust of healthcare providers mirrors similar deteriorations in public guidance related to the climate crisis or vaccine utilization. Dr. Straus reinforced with the audience that skepticism in what you are being told is valuable, and blind acceptance can be equally dangerous. However, in the era of artificial intelligence, massive amounts of misleading or false information are being generated and disseminated at an alarming pace with few guardrails.

What can we do as scientists to counteract this? She offers the advice that we must (1) practice evidence-based healthcare that integrates clinical expertise with evidence and patients’ values, (2) be trustworthy and transparent, avoid unnecessary medical jargon, and be consistent in messaging, and (3) engage with patients, caregivers, and the public to foster health literacy and better understand patient needs while also practicing scientific and clinical humility. She describes the public’s reaction with distrust toward those in medicine as partially understood by the “leaky research pipeline,” with over $250 billion per year being “wasted” on research with poorly defined questions or methodologies, or not reaching the public with papers (or papers that cannot be accessed by the public).

She illustrated her work in implementation science with a project assessing the use of fascia iliaca blocks for elderly patients undergoing hip arthroplasties. In order to effect change, her team had to first assess the problem (why is there a need for change), funnel knowledge (what do we know and what needs to change), assess factors that impede or support change (why should practice change), and lastly interventions (how can things change). Change may be targeted at individuals or multiple people at once and may involve modifications of a single component or multiple components at once. She closed by emphasizing that this is an inspiring opportunity for an inflection point in science – to help the public regain trust of healthcare providers and scientists with evidence-based solutions. In order to do so, we have to be comfortable with sometimes uttering three words that are challenging to say, “I don’t know,” when we are confronted with questions that reach beyond the limits of our knowledge.