Trust in Health Care: Why Physicians Should Trust in Patients (2024)

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    Viewpoint

    Trust in Health Care

    March 22, 2019

    RachelGrob,PhD1; GwenDarien,BA2; DavidMeyers,MD3

    Author Affiliations Article Information

    • 1University of Wisconsin-Madison

    • 2National Patient Advocate Foundation, Washington, DC

    • 3Agency for Healthcare Research and Quality, Rockville, Maryland

    JAMA. 2019;321(14):1347-1348. doi:10.1001/jama.2019.1500

    visual abstract icon Visual Abstract editorial comment icon Editorial Comment related articles icon Related Articles author interview icon Interviews multimedia icon Multimedia audio icon Listen to this article
    • Editorial Trust in Health Care

      HowardBauchner,MD

      JAMA

    • Editorial Building Trust in Health Care—Why, Where, and How

      DhruvKhullar,MD, MPP

      JAMA

    • Viewpoint Trust in Health Care: Physicians’ Trust in One Another

      Richard M.Frankel,PhD; Virginia P.Tilden,PhD; AnthonySuchman,MD, MA

      JAMA

    • David H.Thom,MD, PhD

      JAMA

    • DavidMeyers,MD; GwenDarien,BA; RachelGrob,PhD

      JAMA

    Full Text

    Most of the existing literature on trust between patients and physicians focuses on whether patients trust their clinicians. When medical paternalism was the dominant model in health care, this focus may have been logical: if the physician knows best, the main role of patients is to trust and follow the guidance of physicians. But in the “new age of patient autonomy,”1 a growing, but still limited, evidence base demonstrates the efficacy of patient-physician partnerships and co-produced care to improve quality and safety of care, patient health outcomes, and patient experience. A 2017 National Academy of Medicine report highlighted the potential of shared decision making, advance care planning, and family involvement to improve health outcomes.2 Without intentional cultivation of these often-neglected aspects of patient-physician relationships, increasing reciprocal trust between patients and physicians—an important aspect of both quality of care and positive experiences with care for patients, families, and professionals—will remain an elusive goal.

    • Editorial Trust in Health Care

      JAMA

    • Editorial Building Trust in Health Care—Why, Where, and How

      JAMA

    Full Text

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    3 Comments for this article

    EXPAND ALL

    March 23, 2019

    Trust. The Holy Grail of Medicine

    Edward Volpintesta, MD | Bethel Medical Group

    I know that when I trust a patient I have confidence that my suggestions will be followed, that follow-up appointments will be kept, and that if any problems arise I will be notified quicker rather than later. This is important particularly in conditions that require close monitoring like hypertension and diabetes.

    But trusting a patient takes time. With some, trust occurs at the first visit. With others it takes time. And with others it is difficult and trust is late in coming or never occurs completely.

    In those patients that I trust, a friendship develops that makes taking

    care of them a mutually enjoyable professional-social experience.

    CONFLICT OF INTEREST: None Reported

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    March 23, 2019

    Excellent Viewpoint Article

    Scott Helmers, MD | Retired

    This essay is well worth reading by any practicing physician. The problem I see is that developing trust requires not only effort but time. As medicine has been taken over by corporate profit motivation, rather than individual doctors trying to help and care, how much time is allotted, especially beyond the time one's face is buried in the EHR?

    CONFLICT OF INTEREST: None Reported

    April 11, 2019

    Trust and Health

    Paul Nelson, M.D., M.S. | Family Health Care, P.C. retired

    The ultimate attribute of trust is represented by its independent capability to improve a person's health and its subsequent healthcare. Otherwise, this is definable as "reverse causality." Having spent a few years looking for studies connecting trust, social capital and social cohesion, I found a study using data from the United Kingdom by a research team in Sweden (1). The report's conclusions begins with this sentence: "This study offers empirical evidence to support the circular nature of trust/health relationships."

    A second companion study was adapted for a study of Affordable Care Act outcomes 2006-2014

    (2). Its Abstract begins, "Previous research shows that generalized trust, the belief that most people can be trusted, is conducive to people's health."

    References

    1. Giordano GN, Linstrom M. J Epidemiol Community Health published online First 11-6-2015
    http://dx.doi.org/10.1136/ech-2015-205822

    2. Mewes J, Giordano GN. Social Science & Medicine published online First 8-18-2017
    http://dx.doi.org/10.1016/j.socscimed.2017.08.012

    CONFLICT OF INTEREST: None Reported

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    Grob R, Darien G, Meyers D. Why Physicians Should Trust in Patients. JAMA. 2019;321(14):1347–1348. doi:10.1001/jama.2019.1500

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