Trust in the Medical Profession: Conceptual and Measurement Issues

Abstract

Emerging research on patients' trust has focused on interpersonal trust in a specific, known physician. Trust in physicians in general is also important and differs significantly from interpersonal physician trust. General physician trust potentially has a strong influence on important behaviors and attitudes, and on the formation of interpersonal physician trust.

Heteronormativity and practitioner–patient interaction

“…The scale is strongly correlated with desire to stay with a physician, satisfaction with that physician, willingness to recommend the physician to friends (desire to switch physicians: r = −0.69, satisfaction: r = 0.76, recommend to friends: r = 0.74). Hall et al, (2002b) also found that general trust in physicians is, on average, lower than trust in a specific physician.…”

“…This may lead to fewer behavior-related health changes and, potentially, poorer mental health. The measure of trust we used would also tend to underestimate the general trust in physicians (Hall, et al 2002b). Thus, not only could patients faced with heteronormative communication not trust the doctor, but they may not trust the medical profession as a whole.…”

Development of a Revised Health Care System Distrust Scale

“…Furthermore, this empirical and theoretical evidence not only supports the concept of trust as multidimensional, but is increasingly converging on a model of 2 primary dimensions-one related to perceptions of value congruence and the second to perceptions of competence. This model, initially proposed by Hovland, Janis, and Kelley 16 has been supported by multiple studies in health care [17][18][19][20][21][22] and in other areas [23][24][25][26][27][28][29][30] -and also has the benefit of making conceptual sense. If trust is defined as the belief that some entity will act in one's interest in the future, trust then requires the perception that the entity is capable of doing what is needed (technical competence) and the perception that that the entity wants to do what is needed (value congruence).…”

Trust in an individual physician and its contradictions

“…And this is precisely the reason why trust in the physician is such an important issue for health policy and why so much attention is paid to the characteristics of communication between the patient and the physician as one of the most important factors in establishing trust (see 15,16,17,18,19,20). However, individuals interact with the health system at multiple levels (access to health care in general, the quality of health services, experiences with health workers) and in doing so they take on different social roles (19,21). All levels are potential sources of uncertainty and enjoy more or less trust.…”