Background Patient trust in their clinicians is an important aspect of health care quality, but little evidence exists on what contributes to patient trust. Purpose The aim of this study was to determine workplace, clinician, and patient correlates of patient trust in their clinician. Methodology/Approach The sample used baseline data from the Healthy Work Place trial, a randomized trial of 34 Midwest and East Coast primary care practices to explore factors associated with patient trust in their clinicians. A multivariate "best subset"regression modeling approach was used, starting with an item pool of 45 potential variables. Over 7 million models were tested, with a best subset of correlates determined using standard methods for scale optimization. Skewed variables were transformed to the fifth power using a Box-Cox algorithm. Results The final model of nine variables explained 38% of variance in patient trust at the patient level and 49% at the clinician level. Trust was related mainly to several aspects of care variables (including satisfaction with explanations, overall satisfaction with provider, and learning about their medical conditions and their clinician's personal manner), with lesser association with patient characteristics and clinician work conditions. Conclusion Trust appears to be primarily related to what happens between clinicians and patients in the examination room. Practice Implications System changes such as patient-centered medical homes may have difficulty succeeding if the primacy of physician-patient interactions in inspiring patient trust and satisfaction is not recognized.
Bibliographical noteFunding Information:
In addition to support from the American Board of Internal Medicine Foundation, Dr. Linzer and Ms. Poplau are supported through Hennepin Healthcare by the American Medical Association and the American College of Physicians for research and training in burnout prevention. Dr. Linzer is also supported by the Institute for Healthcare Improvement for work in studying and promoting joy in medicine, by the National Institutes of Health and the Agency for Healthcare Research and Quality, and consults for Harvard University on a grant assessing relationships between work conditions and diagnostic accuracy. Mr. Barbouche runs a data management company in Madison, WI, Forward Health Group, and has stock in the company. Dr. Hicks receives royalties from a book. For the remaining authors, no conflict of interest were declared. Listed coauthors were paid for their time on this project.
This work was supported by the American Board of Internal Medicine Foundation and the Agency for Healthcare Research and Quality (AHRQ Grant 5R18-HS018160-03). Clinical Trial Registration Number: NCT02542995.
© Lippincott Williams & Wilkins.
- interpersonal care
- patient satisfaction
- patient trust
- work conditions
PubMed: MeSH publication types
- Journal Article
- Research Support, U.S. Gov't, P.H.S.
- Research Support, Non-U.S. Gov't