# Diverging trajectories of trust in healthcare and on-line information seeking: what’s next with LLMs

## TL;DR

People increasingly seek health information online, and large language models may change how patients access health guidance, offering opportunities for healthcare systems to adapt and build trust.

## Contribution

The paper highlights the growing role of LLMs in health information seeking and proposes integrating these tools into patient-centric healthcare systems to enhance trust and engagement.

## Key findings

- Public trust in the U.S. healthcare system has declined over 25 years, coinciding with increased online health information seeking.
- LLMs are emerging as a major influence in how patients access personalized health information, potentially shifting the role of clinicians.
- Health systems can improve trust and engagement by integrating online tools patients already use into traditional care models.

## Abstract

As technology evolves, so does the way people engage with it—especially when it comes to health information. Over the past 25 years, the explosive growth in internet use has been paralleled by an equally rapid increase in individuals seeking health information online. During this same period, public trust in the United States healthcare system has steadily eroded. While a direct causal link is unlikely, these trends are interconnected. The primary drivers of declining trust – cost and limited accessibility – have pushed many people to seek alternatives. Yet, health systems have historically paid little attention to the underlying motivations driving people to seek health information independently. The rapid emergence of large language models (LLMs), which provide unprecedented access to personalized and context-aware health information, signals a profound shift in this landscape. As LLMs become increasingly integrated into everyday information-seeking behaviors, they may further supplant clinicians as the initial point of contact for health-related information and guidance. Rather than viewing this long-standing, but rapidly accelerating shift towards patients seeking health guidance online as peripheral to traditional care, patient-centric health systems have an opportunity to harness it. By acknowledging their value to patients and integrating the ways people use online resources to inform their health decisions, systems of care can cultivate greater trust, strengthen health literacy, and deepen patient engagement. Informed by past missteps, the path forward for healthcare rests not in competing with these technologies, but in collaborating with the tools people are already choosing to guide their health.