The Functions and Limitations of Trust in the Provision of Medical Care

Abstract

Trust, the expectation that institutions and professionals will act in one's interests, contributes to the effectiveness of medical care. With the rapid privatization of medical care and the growth of managed care, trust may be diminished. Five important aspects of trust are examined: technical and interpersonal competence, physician agency, physician control, confidentiality, and open communication and disclosure. In each case, changing health care arrangements increase the risks of trusting and encourage regulatory interventions that substitute for some aspects of trust. With the increased size and centralization of health care plans, inevitable errors are attributed to health plans rather than to failures of individual judgment. Such generalized criticisms exacerbate distrust and encourage micromanagement of medical care processes.

Asylum seekers' expectations of and trust in general practice: a qualitative study

“…The author Mechanic suggests that there are five aspects to trust, including trust in the doctor's technical and interpersonal competence, trust in the doctor's control over patients' access to health care, and trust in open communication and disclosure. 16,18 The present study confirms that asylum seekers often come from countries with ready access to specialists and that they struggle to understand why GPs will not refer them on to specialist services. 5 However, if GPs foster and build on the level of trust engendered within individual consultations -through respect and listening to and examining patients -the rapport they develop may give their asylum-seeking patients the confidence to trust them when the consultation does not result in a prescription or referral.…”

“…This building of trust is important, not only for the outcome of individual consultations, but also because it may engender trust in the healthcare system as a whole. [16][17][18] This paper reports on how asylum seekers' previous knowledge and experience of health care in their country of origin has an impact on their expectations of general practice in the UK and their trust of GPs.…”

Stigma and Trust Among Mental Health Service Users

“…Although stigma is considered a barrier to recovery for mental health service users (Link, Struening, Neese-Todd, Asmussen, & Phelan, 2001), the precise intermediate mechanisms that occur within mental health service organizations remain unclear. Since the interaction between service users and providers is a main process within mental health services (Slade et al, 2002), and trust is viewed as a main characteristic of this interaction (Mechanic, 1998;Thorne & Robinson, 1988;Zazzali, 2003), trust may be considered a potentially important intermediate variable linking stigma to outcomes of mental health services. In this study, we will consider the outcome variable service user satisfaction.…”

“…studying general health care have stressed the crucial importance of interpersonal trust in this relationship (Mechanic, 1998;Thorne & Robinson, 1988;Zazzali, 2003). Compared to general health care, research in the domain of mental health care has given little attention to trust (Brown et al, 2009;Laugharne & Priebe, 2006;Piippo & Aaltonen, 2008).…”

The New Trends in Medicine and Trust

“…This tendency leads to standardization of medical practice as it reduces costs. The great damage to the physician-patient relationship in these movements is that the patient is considered secondary, without attention to his individual characteristics and needs [16]. It ignores the individuality and leads to the uniformity.…”