How patient-physician encounters in critical medical situations affect trust: results of a national survey

A random national telephone survey was conducted using validated multi-item questionnaire measuring trust and satisfaction with physicians and with the medical profession. A seven item questionnaire measured the patient-physician encounters in critical medical situations. A total of 1117 subjects aged 20 years and older with health insurance were included for analyses. Spearman rank order correlations were used to determine the association of encounter variables with trust in physicians and the medical profession.Prescription of medications by primary care physicians that patients believed might have side effects was negatively correlated with trust in physician (ρ = -0.12, p < 0.001, n = 1045) in multivariate analysis. A primary care physician evaluating the patient for a condition the patient believed was serious was positively correlated with trust in physician (ρ= 0.08, p < 0.01). Being hospitalized was positively correlated with trust in the medical profession (ρ = 0.12, p < 0.01, n = 475).Hospitalization, perceived seriousness of condition, and concerns about the risks of medications were found to be associated with patient trust in physicians or the medical profession. These findings highlight the salience of trust in serious physician-patient encounters and the role that patient vulnerability plays in determining patient trust.Patients' trust in their physicians is vital for a successful treatment relationship [1,2], which is important for achieving desired treatment outcomes [3-6]. Trust in physicians is a positive acceptance of a vulnerable situation in which patients believe that physicians will care for their interests [7]. Previous studies have identified three sets of factors that are associated with trust: patient characteristics, physician characteristics, and relationship factors. [2,8-26] Numerous factors, such as choice of physician, length of relationship, and managed care settings have been found to be among the stronger predictors of trust.[16]