Your Patients Trust You, but Do They Believe You?

Buddy Creech: [00:00:14] Hi everyone. I'm Buddy Creech and this is Let's Talk ID. Now, while it may seem like trust in science and medicine is very low in the United States right now, maybe our bigger challenge is actually communication. How do we meet the needs of our patients and their families, meeting them where they are, while also holding true to what we know about science, medicine, vaccines, social determinants of health, and much more. So to help us with this, I've asked Doctor Todd Wolynn to join us today. Todd is the executive director of the Trusted Messenger Program, which is a part of the public health nonprofit called PGP, or Public Good Projects. He's been a vaccination advocate for over 30 years, which includes his work as pediatrician, as a clinical vaccine investigator, and as an immunization, confidence and communication researcher. After 30 years as a community pediatrician, Todd began leading the Trusted Messenger program in April of 2026. His work focuses on empowering healthcare providers and the healthcare settings where they work with communication best practices to drive quality care by helping support patients and families increasingly toward evidence-based health decisions. And I've known about Todd for many years. He came and spoke in Nashville to a gathering of our community pediatricians, and people simply raved about what he had to say. So, Todd, I'm really excited that you could join us today and share with us your experience in this, and then just make everything else right with how we communicate with parents and families.

Todd Wolynn: [00:01:43] Thrilled to be here. Thank you so much, Buddy.

Buddy Creech: [00:01:45] Todd, I have to start because I heard you as part of the Cumberland Pediatric Foundation. I've known of your work for a while as pediatrician and then through the Trusted Messenger program. But the first question I want to get to is how did you start? What's your origin story? We talk about it like the X-Men or with like Star Wars, like always hearing the origin stories is helpful. Where did it all start for you and what gets you excited about what you do?

Todd Wolynn: [00:02:12] I'll make it as quick as I can. Back in 2009, I'm reading a full page story that's titled in the Pittsburgh Post Gazette, "The Vaccine Dilemma." Has a picture of a mom kind of standing behind her child. He's about five years old, not making good eye contact with the camera. And she goes on to say that she feels that his diagnosis of autism is likely related to vaccines. But then you read about four paragraphs down further. By the way, this story, the title, “The Vaccine Dilemma," you could read it across the room. The four paragraphs further down, she talks about her two-and-a-half-year-old with a diagnosis of autism, who's received no vaccines. So my head explodes. I'm like, oh my God, this is irresponsible journalism. What is going on here? The title should actually be, "The Genetics of Autism," not the "Vaccine Dilemma." My head explodes. I end up writing my very first op-ed. A guy makes a mistake and favorably responds to the op-ed, and it turns out he's a communications professor. And Buddy, get this. He says something kind, and I find out he's a communications professor and I seek him out. And I'm like, I realize how powerful writing an op-ed and other things are. But here's the kicker, Buddy. That was 20 years into my career. I had gone through medical school. I'd gone through residency. I had actually gone back to get a master of medical management, and I got zero hours of communication training.

Buddy Creech: [00:03:26] Wow.

Todd Wolynn: [00:03:26] And so here it is. This guy ends up teaching me. And here's the funniest part. It is so powerful to me that he teaches me a year of his curriculum. I go back to my partners. I'm like, we need a communications director in our independent pediatric practice. They're like, that's crazy. I could not convince them to bring him on full time. And after he started, within six months, they're like, we need him full time. So there's the origin story. His name's Chad Herman. He was our communications director at Kids Plus Pediatrics, and now at the Trusted Messenger Program, he's our VP of communications and strategy.

Buddy Creech: [00:03:55] You know, it's really interesting, I think, about the things that when I was going through a residency, certainly, and even those early years as a peds ID person, I would moonlight in a general pediatrics office, do different things, and I would laugh sometimes at the utterly, remarkably practical things that I never learned along the way, whether that was basic nutrition. I think I had a six-week block in medical school about nutrition, and that was sufficient. Back in the 90s, I guess I had no formal communications training like you in medical school, very little in residency. And I don't know that that's a fault in the curriculum per se, but my goodness, it's a glaring hole. Right? Okay. Yeah. You'll call a spade a spade, I like it. This is good.

Todd Wolynn: [00:04:41] Here's the problem. When you say communications and I say communications because I know you and I know you're working. I've seen you present. I got to see you at the NCE for the AAP present. I was like, Holy heck, that guy's got amazing communication skills. You used anecdote, narrative storytelling. Great analogies. And you made it just totally tangible and available. Right? But the kicker here is when people hear communications, my biggest fear is particularly in large systems, large health systems. I'll say it ahead of time. I might be a little provocative here, but when they hear communications, I think it's a little bit of this, you know, patting these HCPs on the head like, oh, that's nice. Here's a little communications for you guys. Why don't you go ahead and this will help you with your patients or whatever. But that's the problem. They call it like a soft skill. The way we use communications in our practice. And we were in Pittsburgh in hostile waters, $2 billion IDNs, with pediatric footprints five times our size and 20 times our size. We certainly did not have deeper pockets and we did not have smarter HCPs, but we led across every value-based care metric in our clinically integrated network. We led across every value-based care metric, immunizations, well visits and screenings either alone or tied. How the hell do we do that? With communication. So when I talk to them. And here's the deal. When you go to these big systems, I'm like, look, I want you to think about communication as driving clinical quality, right? Which is value based care metrics, as well as operational success.

Todd Wolynn: [00:06:05] Our practice was voted repeatedly as a top workplace by our own employees. Our Google reviews were through the roof. Our market share was more outsized, even though we were dealing against huge marketing teams in these entities. And how do we do it? Communication, meeting people where they are at, letting them feel heard. And again, of course, let's not forget now and I am holding my phone up, for those of you obviously that can't see me, everybody has something in their pocket or their purse that is delivering them information and oftentimes inaccurate information, trying to get their eyes glued to the screen and their ears glued to the story. And more often than not, and there's a lot of inaccurate information, particularly because algorithms prize sensational content. If I told you today 4 million people got immunized, nobody got hurt, it didn't do anything other than protect them, that's a blip and it goes away because there's nothing sexy about it. And don't forget, on social media, people are trying to get your eyes glued on there because they want to sell your data or they want to sell it to advertisers. So that's what we're up against. And no wonder then our patients are being like led into harm's way by people that take no oath to do no harm.

Buddy Creech: [00:07:13] Todd, this is really interesting. So I have a different perspective over the last year and change because my oldest daughter, they had their first child. And so I'm a grandfather now, which makes me feel like I'm 100 years old, but it's awesome.

Todd Wolynn: [00:07:23] Congratulations.

Buddy Creech: [00:07:23] Thanks, man. But what's interesting is she's utterly pro-vaccine. She has to be because she's my daughter. She knows it's the right thing to do. She's been a participant in clinical trials, both as a kid and as an adult. She is pro it all. But the peer pressure that she began to experience, she's not heavily involved in social media, but just like the new mom conversations that occur, they're being influenced by so many different angles. It gives me pause to figure out, okay, where do people go for source of truth now? For most people who has the right to speak truth into their lives. So I wondered if you would talk a little bit about that, because I think what I want our listener to understand is what does it look like to build trust? What does it look like to have trust? What does it look like for that trust to be effective? And are we still the right people to do all of that?

Todd Wolynn: [00:08:21] As you described to me before we started, this podcast is going to be reaching adult and pediatric infectious disease docs out there. And in this day and age in 2026, I already know how many of you are going to feel because the data is already telling us this. Every visit takes longer. Almost any topic feels contentious. People feel in the healthcare field, beat up. They feel harassed. They feel kind of under pressure, obviously always to generate more views. What I will tell you is there is reason for hope. So this is evidence-based data, I'm going to state, and this comes from Annenberg to KFF to the Edelman Trust Barometer. Trust in my healthcare provider, so these are what people are saying. Trust in my healthcare professional, my healthcare provider, is actually incredibly high. Healthcare providers in general have always been high, right? Nurses always at the top. But if and I hate to say this, sorry for you adult providers, but pediatrics is always right next to nurses. If you break doctors down by where they're at. But healthcare professional in general, and I mean pharmacists and I define this broadly. It could be a school nurse, anybody who's got a patient in front of them or somebody who recognizes them as an authority. We have trust, which is huge. Okay. But trust doesn't equal belief. So you may be trusted, but if somebody's already been impacted by inaccurate information, they may trust you, but they may not believe the recommendation you're making. So how do you get to that with communication. And here's the kicker. None of us doctors, NPS, PAs, pharmacists and nurses, none of us had communication training.

Todd Wolynn: [00:09:56] We kind of referenced this early on. That's what's necessary to really address the dilemma that we're faced with. So communication can come in a couple different ways. Of course, the most impactful way is when you have this precious face to face time, right? So there is the opportunity with good communication, to take somebody who may be reluctant with the recommendation you're making and still getting them over to accept your recommendation. There's lots of different approaches that have been out there. We've seen data on presumptive recommendations. I can actually very quickly take you through the evidence-based methodology that we use. You know, there's various ones out there. The one we use is called AIMS. It stands for announce, inquire, mirror and secure. Mrs. Jones, Susie's due for her Tdap, her HPV and her meningitis vaccines. Let's go ahead and get those done today. Presumptive recommendation. That's the announcement, Mrs. Jones says, you know, she needs that Tdap and that meningitis for school. I think I'm going to hold off on the HPV. I go to I for inquiry. I say, Mrs. Jones, can you tell me a little bit more? I sincerely would like to understand more about what's going on with what the concerns are. Mrs. Jones says, you know, my sister in law sent me a TikTok that says that that HPV vaccine could cause sterilization. Every fiber of our being and training says, pounce on her and tell her that's impossible. Show her the data, because that's where our training fails us.

Todd Wolynn: [00:11:13] But instead of doing that, Buddy, I mirror. I go to M because I'm demonstrating, active listening, and I want her to know that I'm understanding what she says, and I ask for confirmation. So I say, and I mirror back to her, Mrs. Jones, I want to make sure I got this right. Your sister-in-law sent you a TikTok that said the HPV vaccine could cause infertility or sterilization. Did I get that right? Now she knows. I know what's scaring her. And she goes, yes, that is right. And now I can pounce on her, but I will not pounce on her because I'm trying to reach her down here. And I'm holding to my heart because our whole training is go to the head with data, and instead I'm going down here to what's called pathos, to values, beliefs, emotions, fear being the strongest. And now I can actually empathize with her, Buddy. And I can say, if I thought that were true, that would scare the heck out of me. But can I tell you why I got it for my daughter and my twin boys? Anecdote. Storytelling. Genuine. Personal. Right? Obviously, if you don't have a daughter and twin boys, do not use that example because it should finally secure the relationship by thanking her regardless of what she does. Of course, you want to then go into the data and address the infertility myth, but you have to go through these first steps. Announce, inquire, mirror to get down into this part of the chest, the heart, the pathos, the values, beliefs, and emotions to at least allow her to get out of this guarded defensive mode like kind of sympathetic fight or flight to more of a parasympathetic like, okay, I'm willing to hear you out.

Todd Wolynn: [00:12:35] And then she goes, yeah, okay, why did you get it? And I'll say, because this is a horrible virus. Most people are going to get it in their lifetime. And while nine out of ten are not going to keep it as a chronic infection, they're going to clear it. I have no idea of looking around to figure out who the 10% are going to go on to have chronic infections, precancerous cancers, and die. And then I can tell we're about the data about not only is there not data to support infertility with the vaccine, but the opposite is true. If you aren't vaccinated we actually have good data showing an impact infertility. Finally, though, I go to secure and whether she says, you know, I just want to go home, talk to my husband about it, I want to hold off for today on that one. Or she says, let's go ahead and get it. I still thank her. Thank you for letting me talk about why I'm so passionate about it. Thank you for sharing your concerns. And that's when I tell people, what if I could give you an evidence-based methodology that allows you to make a recommendation, stand by the science and then hear people out and build more trust regardless of what they say. That's the goal of AMES. It's not to coerce. Yes, it's about building trust. So.

Buddy Creech: [00:13:30] Okay, so I want to unpack a few of those things because the practical rubber meets the road issue here is that as people listen to that, undoubtedly there's going to be a few different responses. One is going to be, that sounds great and all, but I don't know how to do it. Okay, that sounds fine-ish. Maybe it's a little too soft for their liking. Some might even go a little bit further and say, I'm tired of playing defense all the time. I want to play offense. I do want to pounce. I want to call things out that aren't true. But I think one of the things you said at the end there really resonates with me, is that the goal of any of our encounters, whether that's a conversation about smoking cessation, weight management, vaccine uptake, no matter what it is, it's to secure a stable provider patient relationship so that we can continue to move the needle towards health. And I don't know about you, but the number of times where I've been able to convince another human being of my way of thinking on the first reading of that, or the first announcement of that is very, very low. And I just wonder if we go into those encounters saying, I'm going to try to make this relationship as stable, as secure and as healthy as I can. Maybe that changes our approach a little bit.

Todd Wolynn: [00:14:48] Yeah. Here's the deal. I told you about all the trust data, but I'm also going to tell you, you know, just by the very fact that that patient is sitting in front of you, that there's trust. You do not disrobe and talk about your most personal things if you don't have some degree of trust. You sure as hell don't give somebody your baby undressed to walk out of the room, down the hall to weigh and measure. Unless you have some modicum of trust, they can go elsewhere, right? So they trust you. But again, please, to all of you listening out there, trust is not equal belief. These people are scared. They've already been reached. The reason why they're some 20 something out in Iowa that can send an Instagram reel and get our patients to eat horse ivermectin paste, rather than accept an immunization, is because they're a better communicator than you, but they don't have the same level of trust. Holy crap. Starbucks uses communication to get you to pay $12 for your double pump mocha latte using good communication, right? Every corporation out there, by the way, they all have lower losing trust right now. The data shows it, yet they use communication to the tune of hundreds of billions of dollars.

Todd Wolynn: [00:15:52] And for those of you that aren't out there in the business world, they realize a positive ROI for every dollar spent, they get more than $1 back in products or services sold. And we aren't talking tires, buddy. I'm literally trying to get you to stay healthy. Or if you get sick, to get better as quickly as possible, or if you have a chronic disease to live your best life based on evidence-based recommendations I have based on the best available evidence at that moment. The key here is you can't just force it. And for those that are like, oh, it's too soft. I mean, I'll tell you, I've talked to the crotchety old doctors. They're like, you know what? We need to bring back that book of scary pictures with amputations and rashes. You know, Chad, our VP of communications says you can't scare the fear out of somebody. They're already scared and you can't go to their head with data the data shows in communication, evidence based methodologies around communication is if somebody's already scared, leading with more data or leading with fear makes them more resistant to your recommendation. It is why you have to work on getting like, as we like to say, Aristotle figured this out over 2000 years ago.

Todd Wolynn: [00:16:57] He said pathos, which is emotions, values, and beliefs, is the most powerful path to persuasion, which is why our communication is all about accessing pathos ethos. I already gave you all that data. Annenberg and Kaiser and all that data. They already trust our character and our reputation. Logos, which is intellect, is the third path and is not the strongest. But you need to get there. They want to hear you. They want your evidence-based recommendation. You just can't lead with it when they're resisting. So if you make the presumptive recommendation, they're like, yeah, let's go ahead and do it. You did it for a brother last year. You're done. Thanks so much. Get it done. We'll see you next time. But if they're resistant then, or concerned, and we don't use, by the way, the word hesitant anymore. I know that literature talks about hesitancy and that's okay, but nobody wants to be labeled. So what we've changed the language for our purposes is these are people with questions and concerns, and everybody has a right to have questions and concerns. And we as healthcare professionals should be able to answer questions and concerns.

Buddy Creech: [00:17:56] Boy, I'm going to say amen and amen to that. Two quick comments. One is, I don't know that this podcast is on my rising ninth graders favorites list yet. We're going to get there. But this is exactly what she was learning in one of her literature classes this year, as they wrote persuasive arguments and pieces that were meant to change the hearts and minds of people. The other thing is, you mentioned Aristotle, and you mentioned what we've known for a couple of thousand years. You know, there's this ancient religious approach in most of the world's religions, whether it's catechizing directly and teaching rudimentary elements of whatever the belief structure is, but also the idea of counter catechesis, which is you have heard it said that blah, blah, blah. But I tell you something different. That's, I think, where we're living right now, and it's to your comment about mirroring is when we do an effective mirror, we acknowledge that we've heard what they've heard, or we hear what they are currently telling us. We're not caught off guard by it. We can say, I've heard that concern too. There's a lot of different ways to mirror that. I would think, in addition to what you perfectly said, which was in that moment, make sure you communicate that you have heard their exact concerns.

Todd Wolynn: [00:19:13] And again, there are scientists that work on communication. So there is truth to repeating the myth, can help enforce it.

Buddy Creech: [00:19:21] Yes.

Todd Wolynn: [00:19:21] What we're doing is confirming we understood what they said. So you're right. We're mirroring to that degree. So and if you heard what I said, I do say right. I mirror their words saying, so what you said was the HPV vaccine could cause infertility. Do I have that correct? Notice the next step. When I express empathy, I don't further repeat the myth. I said, if I thought that were true, that would scare the heck out of me too. So what you're validating is the fear. Nobody likes to be scared. Nobody likes to be worried or have angst. What I'm empathizing with and I'm validating their emotions. It sucks to be scared. Can I tell you why I got that for my kids, right? So immediately, if they trust you and they're there, like, think about this, right? Because the word that I'm giving you is bioactive. Think of communication as being bioactive. Now, I told you it can drive clinical quality can drive operational success, but it can move you between sympathetic and parasympathetic. So imagine that you make the recommendation to a patient and they say, no, I don't think so. Or they don't accept the full recommendation. They have literally slipped into a sympathetic kind of fight or flight because they're like, oh, here it comes. I'm going to get bullied, pressured, lectured, demeaned, belittled. Right. But when you respond with the inquiry, the mirror, the empathy, you've actually now helped them put their guard down. They're like, oh, this guy's not here to railroad me or tell me why I'm wrong.

Todd Wolynn: [00:20:37] They actually want to understand more, which is part of the act of listening, right? But here's one more step. I'm going to tell you that we're not realizing. Healthcare providers, when they make a recommendation in 2026 and it's not immediately accepted, they are now slipping into that same fight or flight. They're like, oh crap, it's going to be one of these. Think about it. They're like, oh, they didn't immediately accept what I said. And the patient's now on their guard. The HCPs on their guard, right. Nothing good can come of this situation because you have both people in a defensive mode. So the bioactive nature of communication is first, HCP, healthcare professional, check yourself. Kind of get centered again. Recognize they're scared. They're scared because they've heard something. So you center yourself and say, this isn't a fight. I need to help reach them down here where their values, beliefs and emotions are. So I have a strategy now, which I did not before. What we are literally hearing from docs and other healthcare professionals saying, every time I reach for that doorknob, it's kind of like, is it going to be one of these visits? We're hearing the same thing from pharmacists. I see six people in line. I'm going to just start temperature taking. You know what? I'm not even bringing up vaccines unless they bring it up. What does that mean? I don't want to get into a fight. If they bring it up, I know the temperature taking, is this is a low-risk situation? Now I'll talk about it.

Todd Wolynn: [00:21:48] Same thing with healthcare professionals. We're hearing the same thing. Instead of making a presumptive recommendation, I hear several in our interviews saying, you know, I just say, do you want to hear about vaccines? I said, that's like saying Joey had his two-month exam. His exam looks great. Do you want to put him in the car seat facing rear in an appropriately installed car seat, or you want to put him up in the front seat or on the hood? Because I don't want to make you feel bad. And everybody laughs. I never do that. I'm like, but you're totally doing it. It's just you don't think there's going to be pushback with a car seat conversation. That's temperature taking that feels safe. But if I have to talk about vitamin K, or if I have to talk about immunizations, I'm worried there's going to be a fight, I'm already on guard. And so that's why I'm telling you this communication training, we have not gotten that Aristotelian rhetoric, which I wish I got in medical school but did not. I've gotten that training 20 years into my career, and now it is my full time nonprofit healthcare communication job, and it's something we all need. And by the way, it's applicable to any behavior change. As you pointed out, you could use it for pap smears, mammograms, vitamin K, sunscreen. It's about any kind of behavior change, but you need to reach people where they're at. And right now it's not going to get any better. Social media is able to be geo targeted into their wallet and into their purse.

Buddy Creech: [00:22:57] I just can't tell you how much this resonates with me right now. I mentioned this to you earlier, is that our team right now, our research team, is reading this book, Five Dysfunctions of a Team. It's a classic business book that talks about how a lack of trust among a team can lead to a lack of results, but the way it gets there is through a fear or a loss of conflict. And I'm thinking about in our current instance in the West right now, at least, especially in the United States, I don't know if societally we are doing a good job of maintaining our ability to have healthy, conflicting dialogue with one another. We know how to yell at each other. We know how to make equally incendiary posts about someone else. We know how to stay in a bubble and complain about the opposing argument. But I think we've lost the ability for civil discourse that is dissonant with each other. We know how to talk when we agree. We don't know how to talk when we disagree. And I'm just wondering if one of my takeaways from all of this is it's okay to embrace that conflict. It's okay to embrace disagreement. I don't want to encourage tension. I don't want to encourage anything that's negative about that. But like, I'm kind of excited now about my next overly questioning, overly curious, whatever other words beside hesitant, I can say patient to be able to try out. I think I've got announced. Great, I can do inquire all day long. But this idea of mirroring, moving into securing a relationship with that being the goal, I have to admit I'm kind of excited about this now.

Todd Wolynn: [00:24:41] I honestly do believe that it is something we all need. And again, I was CEO of our practice for the whole last half of my career there. We used communication internally with our own employees to make sure everybody was rowing in the same direction, singing from the same song sheet. Right? Every piece of our practice infused communication and to your point, right, embracing the ability to feel confident about the way we communicate with one another makes a huge difference. I will quote a friend of ours, Dr. Andy Nowak, pediatric infectious disease, who says, you have no idea how much time bad communication takes. Because if you think about this, one of the fights will be like, oh, wait, this sounds like it should take a few extra minutes. And he says, you know, trying to get off the hook and say, oh, okay, you don't want it and just move on. And you leave somebody thinking like, I guess it wasn't that important. And he brings the point of, well, you've just really messed that situation up for that topic. For any health care provider that talks to that patient down the road. So he's also a big supporter of this ability to impact and talk to people and engage them, even when there's disagreement in a way that allows you to navigate this successfully, which requires, again, good communication skills and doesn't always end up in a yes, but can always build more trust. So I'm passionate about this and I, again, I'm truly thankful for being on here and being able to talk to you.

Buddy Creech: [00:25:52] Oh no, it's so exciting to me because I think you're exactly right. We don't have the skill set always to do this. So for those who might be hearing this and they say, okay, this sounds really, really good at all, I don't want to do it poorly, but I don't yet know how to do it. Exactly. Maybe they've got a little bit of tools in their toolbox now with aims. How could they get more formal training in this? How could they get a little bit more competence in this?

Todd Wolynn: [00:26:22] First thing I would recommend is we happen to have a free hour of CME and CE for MDS, DOS, NPS and pharmacists. And it literally covers exactly what we talked about. And it's better than another hour of constipation, because the answer to that is MiraLAX. So I mean, and you can use this for any health care issue that requires talking to a patient around behavior change. So go to our website Trusted Messenger Program. You can sign up for the CME. You can also sign up for our newsletter there. I will say our CE CME modules to the CE for pharmacists is blown up. We have over 1500 people have signed up over just the last several months. It's now being mandated in some training programs. So check that out. The other thing we're doing now is a Train the Trainer program. So we're actually trying to scale this up nationally by doing a seven-hour program that's on site, either coming to Pittsburgh or we take it on the road, and then we can train people to train other people in their institutions. So it's growing fast, and I'm thrilled to help anybody out there. And please jump on to our LinkedIn page. It's one of the best ways to follow what we're doing.

Buddy Creech: [00:27:22] This is awesome. And we'll put these links in the show notes so that you have them and it's easy. Otherwise, just search trusted messenger program and it'll take you right there. Todd, I feel like I could talk to you for a long time until the cows come home for sure. But I'm really excited about this. I'm really thankful for the ways that you are calling us to a different way of communicating with a different set of goals in mind, and all the best on what you're working on. I'll tell you this, if you need any more resources around this, certainly check out the IDSA website, check out the website, check out the Trusted Messengers program with Todd. Gosh, if you need to shoot Todd an email, he'll be happy to respond. He's the nicest guy in the world and just flood him. It's what he believes in and he's passionate about. So this is awesome. Todd, thank you for spending time. Thank you for being generous. This is awesome. We're gonna have to get good at this. And you're one of the ways we can do that. So appreciate you.

Todd Wolynn: [00:28:13] Appreciate it. Thanks again.