Original Research

Journal of General Internal Medicine

, Volume 26, Issue 1, pp 51-57

First online:

The Import of Trust in Regular Providers to Trust in Cancer Physicians among White, African American, and Hispanic Breast Cancer Patients

  • Karen KaiserAffiliated withInstitute for Health Research and Policy, University of Illinois at Chicago (UIC) Email author 
  • , Garth H. RauscherAffiliated withDivision of Epidemiology and Biostatistics, UIC School of Public Health
  • , Elizabeth A. JacobsAffiliated withCook County Hospital and Rush University Medical Center
  • , Teri A. StrenskiAffiliated withUIC School of Public Health
  • , Carol Estwing FerransAffiliated withUIC College of Nursing
  • , Richard B. WarneckeAffiliated withInstitute for Health Research and Policy, University of Illinois at Chicago (UIC)

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Abstract

BACKGROUND

Interpersonal trust is an important component of the patient-doctor relationship. Little is known about patients’ trust in the multiple providers seen when confronting serious illness.

OBJECTIVES

To characterize breast cancer patients’ trust in their regular providers, diagnosing physicians, and cancer treatment team and examine whether high trust in one’s regular provider confers high trust to cancer physicians.

DESIGN

In-person interviews.

PARTICIPANTS

704 white, black, and Hispanic breast cancer patients, age 30 to 79, with a first primary in situ or invasive breast cancer who reported having a regular provider.

MEASURES

We measure trust in: (1) regular provider, (2) diagnosing doctors, and (3) cancer treatment team. Other variables include demographic variables, preventive health care, comorbidities, time with regular provider, time since diagnosis, cancer stage, and treatment modality.

RESULTS

Sixty-five percent of patients reported high trust in their regular provider, 84% indicated high trust in their diagnosing doctors, and 83% reported high trust in their treatment team. Women who reported high trust in their regular provider were significantly more likely to be very trusting of diagnosing doctors (OR: 3.44, 95% CI: 2.27–5.21) and cancer treatment team (OR: 3.09, 95% CI: 2.02–4.72 ). Black women were significantly less likely to be very trusting of their regular doctor (OR: 0.58, 95% CI: 0.38–0.88) and cancer treatment team (OR: 0.45, 95% CI: 0.25–0.80). English-speaking Hispanic women were significantly less trusting of their diagnosing doctors (OR: 0.29, 95% CI: 0.11–0.80).

CONCLUSIONS

Our results suggest that patients are very trusting of their breast cancer providers. This is an important finding given that research with other populations has shown an association between trust and patient satisfaction and treatment adherence. Our findings also suggest that a trusting relationship with a regular provider facilitates trusting relationships with specialists. Additional work is needed to increase interpersonal trust among black women.

KEY WORDS

breast cancer doctor-patient relationships primary care specialty care