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

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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.

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References

  1. Adams, R. J., Smith, B. J., & Ruffin, R. E. (2001). Patient preferences for autonomy in decision making in asthma management. Thorax, 56, 126–131. doi:10.1136/thorax.56.2.126.

    Article  PubMed  CAS  Google Scholar 

  2. Alazri, M. H., & Neal, R. D. (2003). The association between satisfaction with services provided in primary care and outcomes in Type 2 diabetes mellitus. Diabetic Medicine, 20, 486–490. doi:10.1046/j.1464-5491.2003.00957.x.

    Article  PubMed  CAS  Google Scholar 

  3. Arora, N. K., Ayanian, J. Z., & Guadagnoli, E. (2005). Examining the relationship of patients’ attitudes and beliefs with their self-reported level of participation in medical decision-making. Medical Care, 43(9), 865–872. doi:10.1097/01.mlr.0000173560.18607.67.

    Article  PubMed  Google Scholar 

  4. Auerbach, S. M., Penberthy, A. R., & Kiesler, D. J. (2004). Opportunity for control, interpersonal impacts, and adjustment to a long-term invasive health care procedure. Journal of Behavioral Medicine, 27(1), 11–29. doi:10.1023/B:JOBM.0000013641.64651.16.

    Article  PubMed  Google Scholar 

  5. Balkrishnan, R., Dugan, E., Camacho, F. T., & Hall, M. A. (2003). Trust and satisfaction with physicians, insurers, and the medical profession. Medical Care, 41(9), 1058–1064. doi:10.1097/01.MLR.0000083743.15238.9F.

    Article  PubMed  Google Scholar 

  6. Basmajian, J. V. (1999). The third therapeutic revolution: Behavioral medicine. Applied Psychophysiology and Biofeedback, 24(2), 107–116. doi:10.1023/A:1022222327161.

    Article  PubMed  CAS  Google Scholar 

  7. Battaglia, T. A., Finley, E., & Liebschutz, J. M. (2003). Survivors of intimate partner violence speak out: Trust in the patient-provider relationship. Journal of General Internal Medicine, 18(8), 617–623. doi:10.1046/j.1525-1497.2003.21013.x.

    Article  PubMed  Google Scholar 

  8. Bhattacharya, R., & Devinney, T. M. (1998). A formal model of trust based on outcomes. Academy of Management Review, 23(3), 459–472. doi:10.2307/259289.

    Article  Google Scholar 

  9. Bigley, G. A., & Pearce, J. L. (1998). Straining for shared meaning in organization science: Problems of trust and distrust. Academy of Management Review, 23, 405–421. doi:10.2307/259286.

    Article  Google Scholar 

  10. Blanchard, C. G., Labrecque, M. S., Ruckdeschel, J. C., & Blanchard, E. B. (1988). Information and decision-making preferences of hospitalized adult cancer patients. Social Science and Medicine, 27, 1139–1145. doi:10.1016/0277-9536(88)90343-7.

    Article  PubMed  CAS  Google Scholar 

  11. Blau, P. M. (1964). Exchange and power in social life. New York: Wiley.

    Google Scholar 

  12. Bonds, D. E., Camacho, F., Bell, R. A., Duren-Winfield, V. T., Anderson, R. T., & Goff, D. C. (2004). The association of patient trust and self-care among patients with diabetes mellitus. BMC Family Practice, 5, 26. doi:10.1186/1471-2296-5-26.

    Article  PubMed  Google Scholar 

  13. Brody, H. (1992). The healer’s power. New Haven: Yale University Press.

    Google Scholar 

  14. Charles, C., Gafni, A., & Whelan, T. (1999). Decision-making in the physician–patient encounter: Revisiting the shared treatment decision-making model. Social Science and Medicine, 49, 651–661. doi:10.1016/S0277-9536(99)00145-8.

    Article  PubMed  CAS  Google Scholar 

  15. Clever, S. L., Ford, D. E., Rubenstein, L. V., Rost, K. M., Meredith, L. S., Sherbourne, C. D., et al. (2006). Primary care patients’ involvement in decision-making is associated with improvement in depression. Medical Care, 44, 398–405. doi:10.1097/01.mlr.0000208117.15531.da.

    Article  PubMed  Google Scholar 

  16. Coulter, A. (2002). After Bristol: Putting patients at the centre. British Medical Journal, 324, 648–651. doi:10.1136/bmj.324.7338.648.

    Article  PubMed  Google Scholar 

  17. Das, T. K., & Teng, B.-S. (1998). Between trust and control: Developing confidence in partner cooperation in alliances. Academy of Management Review, 23(3), 491–512. doi:10.2307/259291.

    Article  Google Scholar 

  18. Dean, B., Barber, N., & Schachter, M. (2000). What is a prescribing error? Quality in Health Care, 9(4), 232–237. doi:10.1136/qhc.9.4.232.

    Article  PubMed  CAS  Google Scholar 

  19. Donovan, J. L., & Blake, D. R. (1992). Patient non-compliance: Deviance or reasoned decision-making? Social Science and Medicine, 34(5), 507–513. doi:10.1016/0277-9536(92)90206-6.

    Article  PubMed  CAS  Google Scholar 

  20. Earle, T. C., & Siegrist, M. (2006). Morality information, performance information, and the distinction between trust and confidence. Journal of Applied Social Psychology, 36(2), 383–416.

    Google Scholar 

  21. Ende, J., Kazis, L., Ash, A., & Moskowitz, M. A. (1989). Measuring patients’ desire for autonomy: Decision making and information-seeking preferences among medical patients. Journal of General Internal Medicine, 4, 23–30. doi:10.1007/BF02596485.

    Article  PubMed  CAS  Google Scholar 

  22. Fairhurst, K., & Dowrick, C. (1996). Problems with recruitment in a randomized controlled trial of counseling in general practice: Causes and implications. Journal of Health Services Research & Policy, 1(2), 77–80.

    CAS  Google Scholar 

  23. Fiscella, K., Meldrum, S., Franks, P., Shields, C. G., Duberstein, P., McDaniel, S. H., et al. (2004). Patient trust: Is it related to patient-centered behavior of primary care physicians? Medical Care, 42, 1049–1055. doi:10.1097/00005650-200411000-00003.

    Article  PubMed  Google Scholar 

  24. Freburger, J. K., Callahan, L. F., Currey, S. S., & Anderson, L. A. (2003). Use of the trust in physician scale in patients with rheumatic disease: Psychometric properties and correlates of trust in the rheumatologist. Arthritis and Rheumatism, 49(1), 51–58. doi:10.1002/art.10925.

    Article  PubMed  Google Scholar 

  25. Gibson, R., & Singh, J. P. (2003). Wall of silence: The untold story of the medical mistakes that kill and injure millions of Americans. Washington DC: Lifeline Press.

    Google Scholar 

  26. Hack, T. F., Degner, L. F., & Dyck, D. G. (1994). Relationship between preferences for decisional control and illness information among women with breast cancer: A quantitative and qualitative analysis. Social Science and Medicine, 39, 279–289. doi:10.1016/0277-9536(94)90336-0.

    Article  PubMed  CAS  Google Scholar 

  27. Hall, M. A., Dugan, E., Zheng, B., & Mishra, A. K. (2001). Trust in physicians and medical institutions: What is it, can it be measured, and does it matter? The Milbank Quarterly, 79(4), 613–639. doi:10.1111/1468-0009.00223.

    Article  PubMed  CAS  Google Scholar 

  28. Hall, M. A., Zheng, B., Dugan, E., Camacho, F., Kidd, D. E., Mishra, A., et al. (2002). Measuring patients’ trust in their primary care providers. Medical Care Research and Review, 59(3), 293–318. doi:10.1177/1077558702059003004.

    Article  PubMed  Google Scholar 

  29. Holman, H., & Lorig, K. (2000). Patients as partners in managing chronic disease. British Medical Journal, 320, 526–527. doi:10.1136/bmj.320.7234.526.

    Article  PubMed  CAS  Google Scholar 

  30. Kao, A. C., Green, D. C., Zaslavsky, A., Koplan, J. P., & Cleary, P. D. (1998). The relationship between method of physician payment and patient trust. Journal of the American Medical Association, 280, 1708–1714. doi:10.1001/jama.280.19.1708.

    Article  PubMed  CAS  Google Scholar 

  31. Kaplan, S. H., Greenfield, S., & Ware, J. E., Jr. (1989). Assessing the effects of physician-patient interactions on the outcomes of chronic disease. Medical Care, 27(Suppl 3), S110–S127. doi:10.1097/00005650-198903001-00010.

    Article  PubMed  CAS  Google Scholar 

  32. Kohn, K. T., Corrigan, J. M., & Donaldson, M. (1999). To err is human: Building a safer health system. Washington, D.C: National Academy Press.

    Google Scholar 

  33. Kraetschmer, N., Sharpe, N., Urowitz, S., & Deber, R. B. (2004). How does trust affect patient preferences for participation in decision-making? Health Expectations, 7(4), 317–326. doi:10.1111/j.1369-7625.2004.00296.x.

    Article  PubMed  Google Scholar 

  34. Kukla, R. (2005). Conscientious autonomy: displacing decisions in healthcare. The Hastings Center Report, 35(2), 34–44. doi:10.2307/3527761.

    Article  PubMed  Google Scholar 

  35. Lee, Y. Y., & Lin, J. L. (2008). Linking patients’ trust in physicians to health outcomes. British Journal of Hospital Medicine, 69(1), 42–46.

    PubMed  Google Scholar 

  36. Lewicki, R. J., & Mcallister, D. J. (1998). Trust and distrust: New relationships and realities. Academy of Management Review, 23, 438–458. doi:10.2307/259288.

    Article  Google Scholar 

  37. Mahler, H. I., & Kulik, J. A. (1990). Preferences for health care involvement, perceived control and surgical recovery: A prospective study. Social Science and Medicine, 31(7), 743–751. doi:10.1016/0277-9536(90)90169-S.

    Article  PubMed  CAS  Google Scholar 

  38. Mainous, A. G., III., Kern, D., Hainer, B., Kneuper-Hall, R., Stephens, J., & Geesey, M. E. (2004). The relationship between continuity of care and trust with stage of cancer at diagnosis. Family Medicine, 36(1), 35–39.

    PubMed  Google Scholar 

  39. McWilliam, C. L., Brown, J. B., & Stewart, M. (2000). Breast cancer patients’ experiences of patient–doctor communication: A working relationship. Patient Education and Counseling, 30, 191–204. doi:10.1016/S0738-3991(99)00040-3.

    Article  Google Scholar 

  40. Mechanic, D., & Schlesinger, M. (1996). The impact of managed care on patients’ trust in medical care and their physicians. Journal of the American Medical Association, 275(21), 1693–1698. doi:10.1001/jama.275.21.1693.

    Article  PubMed  CAS  Google Scholar 

  41. Messick, D. M., Wilke, H., Brewer, M. B., Kramer, R. M., Zemke, P. E., & Lui, L. (1983). Individual adaptations and structural change as solutions to social dilemmas. Journal of Personality and Social Psychology, 44(2), 294–309. doi:10.1037/0022-3514.44.2.294.

    Article  Google Scholar 

  42. Moerman, D. E. (1983). General medical effectiveness and human biology: Placebo effects in the treatment of ulcer disease. Medical Anthropology Quarterly, 14, 3–16. doi:10.1525/aeq.1983.14.1.05x1179i.

    Article  Google Scholar 

  43. Montori, V. M., Gafni, A., & Charles, C. (2006). A shared treatment decision-making approach between patients with chronic conditions and their clinicians. The case of diabetes. Health Expectations, 9, 25–36. doi:10.1111/j.1369-7625.2006.00359.x.

    Article  PubMed  Google Scholar 

  44. O’Neill, O. (2002). Autonomy and trust in bioethics. Cambridge: Cambridge University Press.

    Google Scholar 

  45. Pearson, S. D., & Raeke, L. H. (2000). Patients’ trust in physicians, many theories, few measures, and little data. Journal of General Internal Medicine, 15, 509–513. doi:10.1046/j.1525-1497.2000.11002.x.

    Article  PubMed  CAS  Google Scholar 

  46. Préau, M., Leport, C., Salmon-Ceron, D., Carrieri, P., Portier, H., Chene, G., et al. (2004). Health-related quality of life and patient-provider relationships in HIV-infected patients during the first three years after starting PI-containing antiretroviral treatment. AIDS Care, 16(5), 649–661. doi:10.1080/09540120410001716441.

    Article  PubMed  Google Scholar 

  47. Ranson, S., & Stewart, J. (1998). Citizenship in the public domain for trust in civil society. In A. Coulson (Ed.), Trust and contracts: Relationships in local government, health and public services. Bristol: The Polity Press.

    Google Scholar 

  48. Roberts, A. H., Kewman, D. C., Mercier, L., & Hovell, M. F. (2001). The power of non-specific effects in healing: Implications for psychosocial and biological treatments. Advances in Mind-Body Medicine, 17(1), 17. doi:10.1054/ambm.2000.0283.

    Article  Google Scholar 

  49. Rotter, J. B. (1980). Interpersonal trust, trustworthiness, and gullibility. The American Psychologist, 35(1), 1–7. doi:10.1037/0003-066X.35.1.1.

    Article  Google Scholar 

  50. Rousseau, D. M., Sitkin, S. B., Burt, R. S., & Camerer, C. (1998). Not so different after all: A cross-discipline view of trust. Academy of Management Review, 23(3), 393–404.

    Google Scholar 

  51. Safran, D. G., Kosinski, M., Tarlov, A. R., Rogers, W. H., Taira, D. H., Lieberman, N., et al. (1998). The primary care assessment survey, tests of data quality and measurement performance. Medical Care, 36(5), 728–739. doi:10.1097/00005650-199805000-00012.

    Article  PubMed  CAS  Google Scholar 

  52. Safran, D. G., Montgomery, J. E., Chang, H., Murphy, J., & Rogers, W. H. (2001). Switching doctors: Predictors of voluntary disenrollment from a primary physician’s practice. The Journal of Family Practice, 50(2), 130–136.

    PubMed  CAS  Google Scholar 

  53. Sainio, C., Lauri, S., & Eriksson, E. (2001). Cancer patients’ views and experiences of participation in care and decision making. Nursing Ethics, 8(2), 97–113.

    PubMed  CAS  Google Scholar 

  54. Say, R., Murtagh, M., & Thomson, R. (2006). Patients’ preference for involvement in medical decision making: A narrative review. Patient Education and Counseling, 60, 102–114. doi:10.1016/j.pec.2005.02.003.

    Article  PubMed  Google Scholar 

  55. Schoorman, F. D., Mayer, R. C., & Davis, J. H. (2007). An integrative model of organizational trust: Past, present, and future. Academy of Management Review, 32(2), 344–354.

    Article  Google Scholar 

  56. Silberg, W. M., Lundberg, G. D., & Musacchio, R. A. (1997). Assessing, controlling, and assuring the quality of information on the internet. Journal of the American Medical Association, 1277(15), 1244–1245. doi:10.1001/jama.277.15.1244.

    Article  Google Scholar 

  57. Smith, C. (2005). Understanding trust and confidence: Two paradigms and their significance for health and social care. Journal of Applied Philosophy, 22(3), 299–316. doi:10.1111/j.1468-5930.2005.00312.x.

    Article  PubMed  Google Scholar 

  58. Stewart-Williams, S., & Podd, J. (2004). The placebo effect: Dissolving the expectancy versus conditioning Debate. Psychological Bulletin, 130(2), 324–340. doi:10.1037/0033-2909.130.2.324.

    Article  PubMed  Google Scholar 

  59. Stirrat, G. M., & Gill, R. (2006). Autonomy in medical ethics after O’Neill. Journal of Medical Ethics, 31, 127–130. doi:10.1136/jme.2004.008292.

    Article  Google Scholar 

  60. Tauber, A. I. (2003). Sick autonomy. Perspectives in Biology and Medicine, 46(4), 484–495. doi:10.1353/pbm.2003.0093.

    Article  PubMed  Google Scholar 

  61. Thom, D. H., & Campbell, B. (1997). Patient-physician trust: An exploratory study. The Journal of Family Practice, 44, 169–176.

    PubMed  CAS  Google Scholar 

  62. Thom, D. H., Kravitz, R. L., Bell, R. A., Krupat, E., & Azari, R. (2002). Patient trust in the physician: Relationship to patient requests. Family Practice, 19(5), 476–483. doi:10.1093/fampra/19.5.476.

    Article  PubMed  Google Scholar 

  63. Thorne, S. E., & Paterson, B. L. (2001). Health care professional support for self-care management in chronic illness: Insights from diabetes research. Patient Education and Counseling, 42, 81–90. doi:10.1016/S0738-3991(00)00095-1.

    Article  PubMed  CAS  Google Scholar 

  64. Trachtenberg, F., Dugan, E., & Hall, M. A. (2005). How patients’ trust relates to their involvement in medical care. The Journal of Family Practice, 54(4), 344–352.

    PubMed  Google Scholar 

  65. Veatch, R. M. (2000). Doctor does not know best: Why in the new century physicians must stop trying to benefit patients. The Journal of Medicine and Philosophy, 25(6), 701–721. doi:10.1076/jmep.25.6.701.6126.

    Article  PubMed  CAS  Google Scholar 

  66. Warren, M. E. (1999). Democratic theory and trust. In M. E. Warren (Ed.), Democracy and trust. Cambridge: Cambridge University Press.

    Google Scholar 

  67. Williams, G. C., Freeman, Z. R., & Deci, E. L. (1998). Supporting autonomy to motivate patients with diabetes for glucose control. Diabetes Care, 21(10), 1644–1651. doi:10.2337/diacare.21.10.1644.

    Article  PubMed  CAS  Google Scholar 

  68. Yamagishi, T., & Kikuchi, M. (1999). Trust, gullibility, and social intelligence. Asian Journal of Social Psychology, 2, 145–161. doi:10.1111/1467-839X.00030.

    Article  Google Scholar 

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Lee, YY., Lin, J.L. Trust but Verify: The Interactive Effects of Trust and Autonomy Preferences on Health Outcomes. Health Care Anal 17, 244–260 (2009). https://doi.org/10.1007/s10728-008-0100-1

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