Patients' commitment to their primary physician and why it matters

Ann Fam Med. 2008 Jan-Feb;6(1):6-13. doi: 10.1370/afm.757.


Purpose: The patient-physician relationship is the cornerstone of health care service delivery. The objectives of this study were to assess the contribution of relationship commitment along with trust to patient-physician relationships and to evaluate the association of commitment and trust with adherence to medical advice and healthy eating behaviors.

Methods: To test the proposed model, we developed a questionnaire that included both existing scales and a scale constructed specifically for the study; the questions addressed trust, commitment, adherence to physicians' medical recommendations, and healthy eating behavior. The questionnaire was given to adult patients in the waiting rooms of 4 large clinics in central Texas.

Results: A total of 1,008 patients returned questionnaires; 869 patients' questionnaires were complete and used in the analysis. A 3-stage least squares analysis that tested a system of 4 equations which included relationship commitment yielded a systemwide R(2) of 0.71 that was 0.09 higher than a system of equations excluding relationship commitment. Trust and commitment were positively associated with adherence (P <.001 and P = .02, respectively). We also found positive relationships between adherence and commitment and between trust and commitment (P <.001 for each). Adherence and commitment were both associated with healthy eating behavior as well (P <.001 for each).

Conclusions: Patients' trust in their physician and commitment to the relationship offer a more complete understanding of the patient-physician relationship. In addition, trust and commitment favorably influence patients' health behaviors.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Attitude to Health
  • Continuity of Patient Care / standards*
  • Diet
  • Feeding Behavior / psychology
  • Female
  • Group Practice
  • Health Behavior
  • Humans
  • Male
  • Middle Aged
  • Patient Acceptance of Health Care / psychology*
  • Physician-Patient Relations*
  • Physicians, Family*
  • Surveys and Questionnaires
  • Trust / psychology