In Healthcare, Sharing Information Is Not Enough – We Need More Dialogue

One of the most important challenges facing Estonia’s healthcare system is not only the financial situation of the Health Insurance Fund, the shortage of healthcare professionals, or access to services. What is becoming increasingly clear is the question of how much effort is being put into communication and, through that, into building trust – and how little healthcare authorities and experts are actually communicating with people.

Although for many people communication with their family doctor has become faster and more convenient, according to Kantar Emor’s 2025 survey, only 40% of Estonian residents consider access to medical care to be good or rather good. At the same time, 66% of residents are confident that their family doctor can help them with most health-related questions, which means that as many as 34% of the population either do not think so or have had a different experience.

Family health centres have made efforts and moved onto digital platforms, such as the e-Family Doctor Centre, which makes communication with a doctor or family nurse easier. However, these platforms still do not offer a sense of community or opportunities for people to relate to one another. Meanwhile, the provision of national, evidence-based health information has remained confined to official, somewhat sterile, static and strictly formal websites.

Patients have moved to social media and community groups, where they look for human interaction and real-life experiences – but experts, unfortunately, have not yet followed them there. At the same time, we could prevent many visits and enquiries to family doctors, and thereby reduce the burden on primary care, if public authorities devoted more time to communicating with people in social media communities. Communicating – not merely sharing information.

A trusting dialogue is missing

At first glance, it may seem that everything in healthcare communication is working as it should: institutions share health-related information and run awareness campaigns. They invite people to screenings and health checks. They publish information on websites and social media channels, using designed materials and various infographics. Experts give advice in newspaper columns and on institutional social media channels, and sometimes they even answer people’s questions. But what is missing is a genuine, long-term dialogue based on trust.

On the one hand, the reason probably lies in the strategic choices made in institutional communication, but also in limited time and financial resources. At the same time, in today’s information channels, people who are not yet considered ill from the perspective of the medical system are also left without professional support and guidance. With whom, and where, should conversations and discussions take place for people who do not have any specific symptoms but want to take a preventive interest in their health and talk about it? The current healthcare system does not support positive health-related curiosity or the desire to deal with one’s health preventively, because the necessary support is lacking – and sometimes so are the skills and knowledge.

At the same time, the Ministry of Social Affairs wants people to take more responsibility for their health and make evidence-based preventive decisions themselves. Somewhere here lies a deep gap between how people actually make decisions, how they want to discuss health, and how institutions and experts support them so that they can make smaller health-related decisions independently.

Social media groups need experts

To build and maintain trust in healthcare, much more is needed than simply sharing the right information in the right channel at the right time. For some reason, the role of communication is often understood as one-directional: the doctor gives the patient information and instructions, and healthcare institutions and the state also tell people how to behave and what to do in certain situations. There seems to be little room for joint discussion and two-way communication.

One example of a community group on Facebook is a group called “Tervis” (“Health”) – which has 32,000 members. The conversations and shared experiences in that group show that people need time and space for discussion, and a calm environment in which to ask questions and share experiences. This is not, in itself, a new phenomenon. In the past, people asked their parents or grandparents – with whom they may even have shared a home – for health-related and general life advice. Now people have started asking for the same kind of advice on social media instead.

Influencers have also entered the information space. In addition to creating communities, they can sometimes influence the reputation of companies and institutions even more than journalism can. Influencers are present for their communities; they share their thoughts and information directly and communicate with their followers consistently. As a result, their advice and recommendations are trusted. It also helps that influencers usually speak about topics in a clear and concise way. Research by Emily Hund from the University of Pennsylvania shows that influencers are trusted more than journalists.

We have seen misinformation spread on social media. This was especially noticeable during the coronavirus pandemic, when science was trying to bring new knowledge about the virus to the public, and information changed fairly often within a short period of time. Although Estonian state institutions did as much as they could in that situation – sharing information and providing explanations – even then, they did not manage to engage in much real dialogue with people. Yet social media is precisely the place through which it is possible to reach both young people and people living in rural areas. It also allows people a degree of anonymity, which is sometimes necessary. Research also shows that social media-based interventions can reduce health inequalities and create better access to health information.

In the United Kingdom, during the coronavirus pandemic, an initiative was tested in which local community representatives, local authorities and a national agency worked together to share information about the coronavirus on social media and answer people’s questions through a dedicated Facebook group. Although the study found that testing such new methods also comes with its own challenges, it concluded that these kinds of initiatives support long-term engagement and the spread of health-related information.

Dialogue takes time, commitment and consistency – all things that communication specialists or experts often do not have enough of alongside their other work. At the same time, it is precisely consistent communication with people and non-judgmental answers to their questions that would help build trust and reduce the impact of misinformation.

Effective communication is not the same as a successful awareness campaign

It is absolutely right that over the years, public institutions have increasingly recognised the important role of communication and have allocated budgetary resources to it. But in today’s new era, where we are constantly competing with information overload, awareness campaigns alone are no longer enough. Successful and effective communication does not consist only of a catchy campaign with a clever message. It also requires strategically thought-through decisions, the right choice of target group and message, consistent and intelligent engagement with people, and the building and maintenance of trust. It also requires measuring the results of communication.

Instead of counting the number of media mentions or social media posts, we should invest more time in getting to know target groups and communicating with them. In other words, before launching communication activities, we should identify the target group’s needs, knowledge and barriers – and take them into account. In practice, however, thorough target group research is done rather rarely, because it requires additional resources and expertise. Yet it is precisely the knowledge gained through research that makes it possible to carry out truly effective campaigns and later assess, through follow-up research, whether the communication activities actually had an impact.

To achieve significant behavioural change, it is also important that the system enables people to act and behave in the desired way. When the system has created an opportunity for people to act appropriately, has been available for dialogue, and has created space for conversation, the foundation for trust has been laid. And the success of communication depends precisely on trust.

The coronavirus pandemic, with its many different aspects and unexpected developments, undoubtedly left its mark on the healthcare system and its credibility – a mark that still affects patients today. For the healthcare system, this means that even now, work must be done not only to build trust, but also to restore it. To do this, institutions need to know their target groups and act consistently to maintain their trust. Public institutions must start treating social media much more strategically as an information channel and be present where conversations about health are actually taking place.

The opinion piece was first published in Delfi.