 |
|
Patient Characteristics and Experiences Associated With Trust in Specialist Physicians
Nancy L. Keating, MD, MPH;
Tejal K. Gandhi, MD, MPH;
E. John Orav, PhD;
David W. Bates, MD, MSc;
John Z. Ayanian, MD, MPP
Arch Intern Med. 2004;164:1015-1020.
Background Nearly half of all medical visits are to specialist physicians, yet little is known about patients' outpatient experiences with specialists or how patients' characteristics and experiences are related to trust in specialist physicians.
Methods We surveyed patients who had a new patient visit with a cardiologist, neurologist, nephrologist, gastroenterologist, or rheumatologist practicing in hospital-based practices (response rate, 73%; N = 417) and inquired about their experiences with care and trust in the specialist physician. We used multivariable models to assess associations of patients' characteristics and experiences with trust.
Results Most patients reported good experiences, and 79% reported complete confidence and trust in the specialist. Black patients were less trusting than white patients (risk ratio [RR], 0.5; 95% confidence interval [CI], 0.2-0.8). Patients were more trusting if they reported that the consultant listened (RR, 1.8; 95% CI, 1.0-2.5), received as much information as they wanted (RR, 1.6; 95% CI, 1.1-1.9), were told what to do if problems or symptoms continued, got worse, or returned (RR, 1.4; 95% CI, 1.2-1.5), were involved in decisions as much as they wanted (RR, 1.5; 95% CI, 1.2-1.8), and spent as much time as they wanted with the specialist (RR, 1.8; 95% CI, 1.3-2.2).
Conclusions Patients reported high levels of trust in specialist physicians after an initial visit. Several specific experiences were associated with higher trust, suggesting that efforts to improve patient-physician interactions may be successful at achieving trust. Such efforts should especially aim to optimize physicians' interactions with black patients, who were less trusting of specialist physicians.
From the Division of General Internal Medicine, Department of Medicine, Brigham and Women's Hospital (Drs Keating, Gandhi, Orav, Bates, and Ayanian), and the Department of Health Care Policy, Harvard Medical School (Drs Keating and Ayanian), Boston, Mass. The authors have no relevant financial interest in this article.
RELATED ARTICLE
Trust: Can We Create the Time?
Joel S. Levine
Arch Intern Med. 2004;164(9):930-932.
EXTRACT
| FULL TEXT
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Does Physician Communication Influence Older Patients' Diabetes Self-Management and Glycemic Control? Results From the Health and Retirement Study (HRS)
Heisler et al.
J. Gerontol. A Biol. Sci. Med. Sci. 2007;62:1435-1442.
ABSTRACT
| FULL TEXT
Disparities in Treatment and Outcome for Renal Cell Cancer Among Older Black and White Patients
Berndt et al.
JCO 2007;25:3589-3595.
ABSTRACT
| FULL TEXT
Rural Community Members' Perceptions of Harm from Medical Mistakes: A High Plains Research Network (HPRN) Study
Van Vorst et al.
J Am Board Fam Med 2007;20:135-143.
ABSTRACT
| FULL TEXT
Racial Differences in Trust and Lung Cancer Patients' Perceptions of Physician Communication
Gordon et al.
JCO 2006;24:904-909.
ABSTRACT
| FULL TEXT
The Role of Patient-Physician Trust in Moderating Medication Nonadherence Due to Cost Pressures
Piette et al.
Arch Intern Med 2005;165:1749-1755.
ABSTRACT
| FULL TEXT
Beyond Advance Directives: Importance of Communication Skills at the End of Life
Tulsky
JAMA 2005;294:359-365.
ABSTRACT
| FULL TEXT
Health Concerns of Patients With Nonbacterial Prostatitis/Pelvic Pain
Turner et al.
Arch Intern Med 2005;165:1054-1059.
ABSTRACT
| FULL TEXT
Trust: Can We Create the Time?
Levine
Arch Intern Med 2004;164:930-932.
FULL TEXT
|
