Patients' Trust in Their Physicians

Department of Health Care Policy, Harvard Medical School, Boston, MA 02115, USA.
Journal of General Internal Medicine (Impact Factor: 3.45). 10/1998; 13(10):681-6. DOI: 10.1046/j.1525-1497.1998.00204.x
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To evaluate the extent to which physician choice, length of patient-physician relationship, and perceived physician payment method predict patients' trust in their physician.
Survey of patients of physicians in Atlanta, Georgia.
Subjects were 292 patients aged 18 years and older.
Scale of patients' trust in their physician was the main outcome measure. Most patients completely trusted their physicians "to put their needs above all other considerations" (69%). Patients who reported having enough choice of physician (p < .05), a longer relationship with the physician (p < .001), and who trusted their managed care organization (p < .001) were more likely to trust their physician. Approximately two thirds of all respondents did not know the method by which their physician was paid. The majority of patients believed paying a physician each time a test is done rather than a fixed monthly amount would not affect their care (72.4%). However, 40.5% of all respondents believed paying a physician more for ordering fewer than the average number of tests would make their care worse. Of these patients, 53.3% would accept higher copayments to obtain necessary medical tests.
Patients' trust in their physician is related to having a choice of physicians, having a longer relationship with their physician, and trusting their managed care organization. Most patients are unaware of their physician's payment method, but many are concerned about payment methods that might discourage medical use.

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Available from: Paul D Cleary, Oct 10, 2015
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    • "The role of choice, however, is also paramount in discerning between trust and related concepts (Calman 2002, Calnan and Rowe 2008, Kao et al. 1998). In addition, Luhmann argued for distinctions between trust/confidence (Luhmann 1979, 1988, 1995) and trust/familiarity (Luhmann 2000). "
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    ABSTRACT: Colorectal cancer (CRC) has the second highest cancer prevalence and mortality rates in Australia. The Australian National Bowel Cancer Screening Program (NBCSP) aims to increase early detection of CRC by offering free faecal occult blood testing. The NBCSP aims to offer choice to consumers about whether or not to participate in screening. This article presents data on trust, choice and perceived obligation to participate in the NBCSP by population groups with low uptake. A qualitative study was undertaken in South Australia. We interviewed 94 people from four culturally distinct groups: Greek, Iranian, Anglo-Australian and Indigenous peoples. This article demonstrates the complexity of factors shaping the choice, or lack thereof, to participate in the NBCSP. Informed choice is based on adequate knowledge, although this varied among our participants, highlighting the need for more health education in appropriate languages. An obligation to participate was found in the Iranian and Anglo-Australian groups and resulted from an established personal relationship with the doctor, a sense of duty, the acknowledgement of government investment and appreciation. Overall, this article makes a link between trust, choice and obligation, adding to literature on the sociology of trust and medical screening and highlighting important issues in the need of a policy and practice to improve CRC screening rates. © 2015 Foundation for the Sociology of Health & Illness.
    Sociology of Health & Illness 09/2015; 37(7):988-1006. DOI:10.1111/1467-9566.12280 · 1.88 Impact Factor
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    • "Patient trust was measured with a four-item instrument that assessed each dimension of Hall's framework (Hall et al. 2001) of patient trust in the physician: trust in the physician's competence, overall global trust, fidelity aspects of trust, and honesty (Kao et al. 1998). The four survey questions included: How much do you trust your physician's judgment about your medical care? "
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    ABSTRACT: Objectives: To examine the associations between racial/ethnic concordance and blood pressure (BP) control, and to determine whether patient trust and medication adherence mediate these associations. Design: Cross-sectional study of 723 hypertensive African-American and white patients receiving care from 205 white and African-American providers at 119 primary care clinics, from 2001 to 2005. Racial/ethnic concordance was characterized as dyads where both the patient and physician were of the same race/ethnicity; discordance occurred in dyads where the patient was African-American and the physician was white. Patient perceptions of trust and medication adherence were assessed with self-report measures. The BP readings were abstracted from patients' medical charts using standardized procedures. Results: Six hundred thirty-seven patients were in race/ethnic-concordant relationships; 86 were in race/ethnic-discordant relationships. Concordance had no association with BP control. White patients in race/ethnic-concordant relationships were more likely to report better adherence than African-American patients in race/ethnic-discordant relationships (OR: 1.27, 95% CI: 1.01, 1.61, p = 0.04). Little difference in adherence was found for African-American patients in race/ethnic-concordant vs. discordant relationships. Increasing trust was associated with significantly better adherence (OR: 1.17, 95% CI: 1.04, 1.31, p < 0.01) and a trend toward better BP control among all patients (OR: 1.26, 95% CI: 0.97, 1.63, p = 0.07). Conclusions: Patient trust may influence medication adherence and BP control regardless of patient-physician racial/ethnic composition.
    Ethnicity and Health 11/2013; 19(5). DOI:10.1080/13557858.2013.857764 · 1.67 Impact Factor
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    • "124). There are numerous instruments for measuring trust in interpersonal and organisational relationships (Rotter 1967; Larzelere and Huston 1980; Cummings and Bromily 1996), some of which are specific to health care, including those that measure patients' trust in physicians (Anderson and Dedrick 1990; Kao et al. 1998), primary care providers (Safran et al. 1998), the medical profession (Hall et al. 2002), and nurses (Radwin and Cabral 2010). However, studies aimed specifically at measuring trust in health-care providers, health-care institutions, and health-care payers are limited. "
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    ABSTRACT: Abstract: The importance of trust within health care is widely acknowledged. Measuring patients' trust in health care systems may contribute to plans for the financing, delivery, and outcomes of health services. Although many scales are available to measure patient trust, less attention has been paid to the multidimensional nature of trust in health care systems. The purpose of this methodological study was to adapt the Multidimensional Trust in Health-Care Systems Scale into Turkish and to evaluate its psychometric properties for a Turkish patient population. The scale was adapted into Turkish through a translation and back-translation process. The content validity of the scale was assessed using expert approval. The psychometric properties of the scale were investigated by collecting data from 232 hospitalised patients in Ankara during theperiod of 1 January-30 December 2010. An exploratory factor analysis identified that the eigenvalues for the three factors of the scale were 7.30, 2.61, and 1.21; these three factors explained 65 % of the variance. A confirmatory factor analysis indicated a sufficient model fit for the construct validity of the scale. Cronbach's alpha for the total scale was 0.87, as well as 0.91, 0.82, and 0.61 for the three subscales; the Spearman-Brown split half reliability coefficient was 0.67. Despite the low internal consistency of the subscale 3, evidence from this study supports the validity and reliability of the Multidimensional Trust in Health-Care Systems Scale. This instrument can be used to measure multiple aspects of trust in the health care system; however, as trust is a contextual phenomenon, further work is needed to test the psychometric properties of this scale both in Turkish and different cultures.
    Social Indicators Research 08/2013; 113(1):107-120. DOI:10.1007/s11205-012-0084-y · 1.40 Impact Factor
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