What if the people Americans trust most in healthcare are the ones they hear from least?
The inaugural SachsHEALTH Influence Index measures that disconnect, identifies where trust barriers exist, and shows how advocacy leaders can address them.
Volume 1
Inaugural Report
2,500
U.S. Adults
±2.0 PTS
Margin
Just 52% of Americans trust the U.S. healthcare system to act in patients’ best interests. But trust has not evaporated evenly. It has moved. Americans still trust their own doctor, nurse, pharmacist, and hospital. Local and state health departments outperform Washington.
And yet the voices Americans trust most are largely absent from the public conversation, while the ones they trust least are setting the terms.
This is the Influence Gap: the divide between who Americans believe shapes the public healthcare narrative today and who they think should.
The disconnect between who Americans believe has influence over the healthcare system and who they believe should have influence is not abstract, but tangibly changes behavior.
In the past year, 42% of Americans deliberately acted against their clinician's recommendations because of a lack of trust in the healthcare system.
This is active noncompliance, driven by a trust deficit that reaches beyond the exam room.
No group has a wider gap between perceived influence and desired influence than clinicians.
Only 26% say doctors and nurses are among the most influential voices in healthcare today, but 58% say they should be. Insurers show the reverse: 51% perceived influence, but only 15% think they should have it. Americans want the people who care for them to speak louder. They want the industries that set prices to speak less.
The gap between who Americans trust and who actually shapes their healthcare is the defining tension in the system today.
Ryan Cohn · Partner & Chief Strategy Officer, Sachs Media
The Influence Gap
Perceived influence today vs. desired influence, by group.
Americans Want More Influence
Clinicians
Doctors · Nurses
Patient Advocacy
Nonprofits
Scientists
Researchers
Hospitals
Health Systems
Reaching the skeptical requires showing your work, and
the messenger matters.
Sources Most Likely to Change Someone's Mind About a Health Policy Proposal
Personal Doctor
or Clinician
Independent
Research Org
Nurse or
Clinician
Friend or
Family Member
Ready to go deeper?
Ryan Cohn, Dr. Karen Cyphers, and Byron Johnson will walk your leadership team through what these findings mean for your organization, filtered for your sector and audience.
Briefings are led by the same strategists who designed the research and advise healthcare leaders on the communications implications every day.
Partner and Chief Strategy Officer
Partner and Chief Research Officer
Vice President, Health
Executive Briefing
National findings, sector-specific implications. SachsHEALTH offers complimentary executive briefings tailored to your organization’s competitive position and communications priorities.
Key survey findings filtered for your sector and audience.
How the trust-power gap specifically affects your type of organization.
Concrete insights and next steps for communications and positioning.
Live Q&A with our research and strategy leads.
Issue and controversy-specific findings on vaccine policy, environmental health, litigation environments, telehealth, and mental health.
Book Your Briefing
We’ll respond within two business days to schedule.
About This Report
Methodology
Sample Size
N = 2,500
Margin of Error
± 2.0 PTS
Scope
National
A national survey of 2,500 U.S. adults, fielded February 2026. The instrument included both traditional opinion questions and controlled experiments that tested messenger, framing, and policy authorization effects. Designed and analyzed by Karen Cyphers, Ph.D., Chief Research Officer of Sachs Media's Breakthrough Research division. Cross-tabulations by political ideology, age, race/ethnicity, gender, household income, insurance status, and region. Margin of error approximately ±2.0 percentage points at the 95% confidence level.
