Factors affecting patients’ trust and confidence in GPs: evidence from the English national GP patient survey

Abstract

ObjectivesPatients’ trust in general practitioners (GPs) is fundamental to effective clinical encounters. Associations between patients’ trust and their perceptions of communication within the consultation have been identified, but the influence of patients’ demographic characteristics on these associations is unknown. We aimed to investigate the relative contribution of the patient's age, gender and ethnicity in any association between patients’ ratings of interpersonal aspects of the consultation and their confidence and trust in the doctor.DesignSecondary analysis of English national GP patient survey data (2009).SettingPrimary Care, England, UK.ParticipantsData from year 3 of the GP patient survey: 5 660 217 questionnaires sent to patients aged 18 and over, registered with a GP in England for at least 6 months; overall response rate was 42% after adjustment for sampling design.Outcome measuresWe used binary logistic regression analysis to investigate patients’ reported confidence and trust in the GP, analysing ratings of 7 interpersonal aspects of the consultation, controlling for patients’ sociodemographic characteristics. Further modelling examined moderating effects of age, gender and ethnicity on the relative importance of these 7 predictors.ResultsAmong 1.5 million respondents (adjusted response rate 42%), the sense of ‘being taken seriously’ had the strongest association with confidence and trust. The relative importance of the 7 interpersonal aspects of care was similar for men and women. Non-white patients accorded higher priority to being given enough time than did white patients. Involvement in decisions regarding their care was more strongly associated with reports of confidence and trust for older patients than for younger patients.ConclusionsAssociations between patients’ ratings of interpersonal aspects of care and their confidence and trust in their GP are influenced by patients’ demographic characteristics. Taking account of these findings could inform patient-centred service design and delivery and potentially enhance patients’ confidence and trust in their doctor.

Older patients and their GPs: shared decision making in enhancing trust

“…7 There are positive associations between patients' trust and their involvement in decisions about their health care, which increase with patient age. 32 Despite a greater frequency of GP consultations for older patients, 25 and recognition of the importance of patientcentred care for this age group, 16 there is variability in their participation in shared decision making 33 and inequality in primary healthcare outcomes. 17,26 This study involved detailed individual interviews with 20 older patients attending their GP.…”

“…A recent quantitative study 32 revealed that a sense of shared decision making was particularly associated with the expression of trust in doctors among older patients when compared with younger patients. This finding contrasts with previous literature suggesting that older patients may prefer a more passive focus on receiving information, rather than on active participation in decisions, 29,33 and with literature suggesting that trust can impede, as well as facilitate, older patients' involvement.…”

Ethnic inequalities in doctor-patient communication regarding personal care plans: the mediating effects of positive mental wellbeing

“…Studies suggest ethnic inequalities in doctor patient interactions (Burt et al 2016, Volz, Moore, and Belkora 2015, Ahmed et al 2015, Croker et al 2013, Wong et al 2014, Murray Garcia et al 2000, Lyratzopoulos et al 2012). In the UK people of South Asian descent generally report poorer doctor patient experiences compared with Caucasians (Ahmed et al 2015, Burt et al 2016).…”

Money, media, and general practice

“…It comes as little surprise, therefore, that results from national patient satisfaction surveys tell us that an overwhelming majority of patients have trust and confidence in their GPs. 1 The uniqueness of the patient-doctor relationship in primary care lies in the fact that it crosses family generations and spans the entire spectrum of health and illness. However, in the past decade, government policy and the subsequent media coverage has meant that GPs are increasingly associated with money and this poses a real threat to this important bond.…”