Patients' trust in their physicians: effects of choice, continuity, and payment method

J Gen Intern Med. 1998 Oct;13(10):681-6. doi: 10.1046/j.1525-1497.1998.00204.x.


Objective: To evaluate the extent to which physician choice, length of patient-physician relationship, and perceived physician payment method predict patients' trust in their physician.

Design: Survey of patients of physicians in Atlanta, Georgia.

Patients: Subjects were 292 patients aged 18 years and older.

Measurements and main results: Scale of patients' trust in their physician was the main outcome measure. Most patients completely trusted their physicians "to put their needs above all other considerations" (69%). Patients who reported having enough choice of physician (p < .05), a longer relationship with the physician (p < .001), and who trusted their managed care organization (p < .001) were more likely to trust their physician. Approximately two thirds of all respondents did not know the method by which their physician was paid. The majority of patients believed paying a physician each time a test is done rather than a fixed monthly amount would not affect their care (72.4%). However, 40.5% of all respondents believed paying a physician more for ordering fewer than the average number of tests would make their care worse. Of these patients, 53.3% would accept higher copayments to obtain necessary medical tests.

Conclusions: Patients' trust in their physician is related to having a choice of physicians, having a longer relationship with their physician, and trusting their managed care organization. Most patients are unaware of their physician's payment method, but many are concerned about payment methods that might discourage medical use.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Choice Behavior
  • Cluster Analysis
  • Confidence Intervals
  • Continuity of Patient Care / statistics & numerical data
  • Cost-Benefit Analysis
  • Data Collection
  • Evaluation Studies as Topic
  • Female
  • Georgia
  • Humans
  • Insurance, Physician Services
  • Male
  • Managed Care Programs / economics
  • Managed Care Programs / statistics & numerical data*
  • Middle Aged
  • Patient Satisfaction / statistics & numerical data*
  • Physician-Patient Relations*
  • Random Allocation
  • Regression Analysis
  • Reimbursement Mechanisms
  • Trust*
  • Withholding Treatment