Trust but Verify: The Interactive Effects of Trust and Autonomy Preferences on Health Outcomes

Abstract

Patients' trust in their physicians improves their health outcomes because of better compliance, more disclosure, stronger placebo effect, and more physicians' trustworthy behaviors. Patients' autonomy may also impact on health outcomes and is increasingly being emphasized in health care. However, despite the critical role of trust and autonomy, patients that naïvely trust their physicians may become overly dependent and lack the motivation to participate in medical care. In this article, we argue that increased trust does not necessarily imply decreased autonomy. Furthermore, patients with high levels of trust and autonomy preferences are most likely to have the best health outcomes. We propose a framework for understanding simultaneous trust and autonomy preferences and for recognizing their interactive effects on health outcomes in the dynamic medical encounter. This framework argues that policy makers and health care providers should make efforts to foster not only patients' trust but also their preferences for autonomy and thus gain the best position for achieving health-related goals.

It's Better to Give Than to Receive: The Role of Social Support, Trust, and Participation on Health-Related Social Networking Sites

“…Moreover, in the health communication literature, specifically, it has been shown that trust in physicians is associated with better health outcomes because trusting patients are more likely to adhere to treatment recommendations (Lee & Lin, 2009;Thom, Hall & Pawlson, 2004). Similarly, trust in media has also been associated with health-related outcomes.…”

Cancer Patients' Experience of Combined Treatment With Conventional and Traditional Chinese Medicine

“…This phenomenon may be due to the paternalistic nature of the patient-physician relationship in Taiwan. 46,47 Moreover, participants had a similar passive attitude toward their involvement in the medical decision-making process regardless of dealing with conventional medical clinicians or TCM practitioners. In contrast, CAM users from Western countries tend to participate more and be more active in medical decision making.…”

“…15,44,48 It is possible that the naive trust and overdependence on physician in Chinese culture may have caused the difference. 46 …”

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“…16 This is considered appropriate because of both, the costs and dangers of blind trust wherein there is a risk of corruption, exploitation, or domination particularly for those with a lack of resources, as well as due to the imperatives related to patient autonomy preferences. 18 Another important way of understanding trust relations in the context of healthcare is to distinguish between interpersonal trust – the trust between individual patient and individual care provider/doctor, and institutional trust, which relates primarily to trust in the medical profession or in the healthcare system. Some authors refer to the latter as systems trust, which signifies “accountability and the checks and balances and systems that maintain fairness, preventing incompetence or malign intent”(p. 9).…”