By Shannon Firth

Nurses remained the most trusted profession in the U.S., while medical doctors dropped to the fifth spot, according to Gallup's 2023 Honesty and Ethics poll.

Out of 23 professions, 78% of surveyed adults rated nurses as having "very high or high" honesty and ethical standards, while 56% said the same for medical doctors.

But the degree of trust across nearly all professions has fallen, with the percentage for doctors down 6 points versus the year prior (when it held the second spot in the rankings), and the percentage for nurses 7 points lower than in 2019 and 11 points lower than its peak in 2020.

"Nurses are an essential part of healthcare. Nurses spend more time with patients than any other healthcare provider, and patients can trust the person who is at their side," said Rayna Letourneau, PhD, RN, executive director of the Florida Center for Nursing, in an email.

"While nursing is still rated the most ethical profession, last year's rating was down to the lowest level since 2004. And that might be in part to things like allegations of fraudulent nursing programs," she added.

In early 2023, federal investigators uncovered a network of individuals selling fraudulent nursing diplomas and transcripts from private nursing schools, charging each "student" approximately $10,000 to $20,000 for fake academic credentials. Using these sham papers, buyers could take the national nursing board exam. Those who passed received nursing licenses that enabled them to obtain jobs as RNs and licensed vocational or licensed practical nurses.

As of December, 27 defendants have been charged and convicted in 2023 for their role in the "diploma mill" scheme, according to the U.S. Attorney's office.

Letourneau stressed the importance of addressing "unethical behavior in our profession and implement[ing] strategies to ensure it does not continue," while also "promot[ing] nursing excellence programs and the positive image of nursing."

Nurses were trailed in the 2023 trust poll by veterinarians (65%), and engineers (60%) who placed second and third. Dentists (59%) and pharmacists (55%) rounded out the top six.

Advertising practitioners (8%), car salespeople (8%), and senators (8%) all landed in the single-digits for trustworthiness, with members of Congress dead last at 6%, according to the poll.

Overall, trust in nearly every surveyed profession has fallen since 2019, with the exception of labor union leaders whom only 25% of Americans view as honest and ethical.

Megan Brennan, a research consultant, and Jeffery Jones, described the rationale behind this pattern of waning trust in a news article. "The image of many professions -- particularly those in the medical field -- sharply improved in 2020 amid the COVID-19 pandemic. However, that effect was short-lived, and many ratings have since declined to all-time lows," they wrote.

Notably, despite being ranked in sixth place, pharmacists ratings reached "new lows" in 2023. Of the professions also included in 2019's poll, ratings for honesty and ethics dipped 6 percentage points on average.

Close to half of the 23 professions surveyed in 2023 reflect "meaningful differences by education level," meaning that respondents with a college degree rate professionals more positively than non-college graduates. Nurses and doctors were more likely to be viewed as having "very high or high" honesty and ethical standards among respondent who graduated college (85% and 64%, respectively) compared with respondents who did not (75% and 52%).

The poll also spotlighted partisan differences between Democratic and Republican respondents when it came to viewing nurses (85% vs 74%) and doctors (67% vs 48%) as having very high or high honesty and ethical standards.

The authors noted that party differences may be influenced in part by having a sitting Democratic president. "In 2019, the last time these items were asked and when Republican Donald Trump was in office, about half as many professions as today showed meaningful party differences," they noted.

The latest ratings are from telephone interviews conducted from Dec. 1 to Dec. 20, 2023. The poll was based on a random sample of 1,013 adults living in all 50 states and the District of Columbia.

"In addition to sampling error, question wording and practical difficulties in conducting surveys can introduce error or bias into the findings of public opinion polls," the authors noted.