Journal of General Internal Medicine

, Volume 15, Issue 7, pp 509–513 | Cite as

Patients’ trust in physicians: Many theories, few measures, and little data

  • Steven D. PearsonEmail author
  • Lisa H. Raeke


Trust is one of the central features of patient-physician relationships. Rapid changes in the health care system are feared by many to be threatening patients’ trust in their physicians. Yet, despite its acknowledged importance and potential fragility, rigorous efforts to conceptualize and measure patient trust have been relatively few. This article presents a synopsis of theories about patient trust and the evolution of methods to measure it. Clinicians, educators, and researchers interested in this area may find this information useful in practice and teaching. The gaps identified in our knowledge about trust can help target new efforts to strengthen the methodological basis of work to understand this vital element of medical relationships.


Social Trust Physician Scale Interpersonal Trust Improve Health Status Patient Trust 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Mechanic D, Schlesinger M. The impact of managed care on patients’ trust in medical care and their physicians. JAMA. 1996;275:1693–7.PubMedCrossRefGoogle Scholar
  2. 2.
    Kao AC, Green DC, Zaslavsky AM, Koplan JP, Cleary PD. The relationship between method of physician payment and patient trust. JAMA. 1998;280:1708–14.PubMedCrossRefGoogle Scholar
  3. 3.
    Emanuel EJ, Dubler NN. Preserving the physician-patient relationship in the era of managed care. JAMA. 1995;273:323–9.PubMedCrossRefGoogle Scholar
  4. 4.
    Mechanic D. Changing medical organization and the erosion of trust. Milbank Q. 1996;74:171–89.PubMedCrossRefGoogle Scholar
  5. 5.
    Gray BH. Trust and trustworthy care in the managed care era. Health Aff (Millwood). 1997;16:34–49.CrossRefGoogle Scholar
  6. 6.
    Luhman N. Trust and Power. New York, NY: John Wiley & Sons; 1989.Google Scholar
  7. 7.
    Barber B. The Logic and Limits of Trust. New Brunswick, NJ: Rutgers; 1983.Google Scholar
  8. 8.
    Gambetta D. Trust: Making and Breaking Cooperative Relations. Oxford, UK: Basil Blackwell; 1988.Google Scholar
  9. 9.
    Kramer RM, Taylor TR, eds. Trust in Organizations: Frontiers of Theory and Research. Thousand Oaks, Calif: Sage; 1996.Google Scholar
  10. 10.
    Lewis JD, Weigert A. Trust as a social reality. Social Forces. 1985;3:967–85.CrossRefGoogle Scholar
  11. 11.
    Baier A. Trust and antitrust: trust and its varieties. Ethics. 1986;96:231–60.CrossRefGoogle Scholar
  12. 12.
    Gurtman MB. Trust, distrust, and interpersonal problems: a circumplex analysis. J Pers Soc Psychol. 1992;62:989–1002.PubMedCrossRefGoogle Scholar
  13. 13.
    Anderson LA, Dedrick RF. Development of the Trust in Physician Scale: a measure to assess interpersonal trust in patient-physician relationships. Psychol Rep. 1990;67:1091–100.PubMedCrossRefGoogle Scholar
  14. 14.
    Thom DH, Campbell B. Patient-physician trust: an exploratory study. J Fam Pract. 1997;44:169–76.PubMedGoogle Scholar
  15. 15.
    Caterinicchio RP. Testing plausible path models of interpersonal trust in patient-physician treatment relationships. Soc Sci Med. 1979;13A:81–99.Google Scholar
  16. 16.
    Mechanic D. The functions and limitations of trust in the provision of medical care. J Health Polit Policy Law. 1998;23:661–86.PubMedGoogle Scholar
  17. 17.
    Goold SD. Money and trust: relationships between patients, physicians, and health plans. J Health Polit Policy Law 1998;23:687–95.PubMedGoogle Scholar
  18. 18.
    Safran DG, Kosinski M, Tarlov AR, et al. The Primary Care Assessment Survey: tests of data quality and measurement performance. Med Care. 1998;36:728–39.PubMedCrossRefGoogle Scholar
  19. 19.
    Kao AC, Green DC, Davis NA, Koplan JP, Cleary PD. Patients’ trust in their physicians: effects of choice, continuity, and payment method. J Gen Intern Med. 1998;13:681–6.PubMedCrossRefGoogle Scholar
  20. 20.
    Grumbach K, Selby JV, Damberg C, et al. Resolving the gatekeeper conundrum: what patients value in primary care and referrals to specialists. JAMA. 1999;282:261–6.PubMedCrossRefGoogle Scholar
  21. 21.
    Cleary PD, Edgman-Levitan S, Roberts M, et al. Patients evaluate their hospital care: a national survey. Health Aff (Millwood). 1991;10:254–67.CrossRefGoogle Scholar
  22. 22.
    Thom DH, Bloch DA, Segal ES. An intervention to increase patients’ trust in their physicians. Acad Med. 1999;74:195–8.PubMedCrossRefGoogle Scholar
  23. 23.
    Safran DG, Taira DA, Rogers WH, Kosinski M, Ware JE, Tarlov AR. Linking primary care performance to outcomes of care. J Fam Pract. 1998;47:213–20.PubMedGoogle Scholar
  24. 24.
    Ware JE Jr., Hays RD. Methods for measuring patient satisfaction with specific medical encounters. Med Care. 1988;26:393–402.PubMedCrossRefGoogle Scholar
  25. 25.
    Wolf MH, Putnam SM, James SA, Stiles WB. The Medical Interview Satisfaction Scale: development of a scale to measure patient perceptions of physician behavior. J Behav Med. 1978;1:391–401.PubMedCrossRefGoogle Scholar
  26. 26.
    Brazier JE, Harper R, Jones NM, et al. Validating the SF-36 health survey questionnaire: new outcome measure for primary care. BMJ. 1992;305:160–4.PubMedGoogle Scholar
  27. 27.
    Jenkinson C, Coulter A, Wright L. Short form 36 (SF36) health survey questionnaire: normative data for working adults. BMJ. 1993;306:1437–40.PubMedCrossRefGoogle Scholar

Copyright information

© Society of General Internal Medicine 2000

Authors and Affiliations

  1. 1.the Center for Ethics in Managed CareHarvard Medical School and Harvard Pilgrim Health CareBoston

Personalised recommendations