The import of trust in regular providers to trust in cancer physicians among white, African American, and Hispanic breast cancer patients

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.