Building Doctor Patient Trust

Trust as a construct in healthcare is complicated and multidimensional

- Dr Garima Singh

Whose doctor is it anyway? This is the most crucial question in today’s healthcare system. Patients are wondering if doctors are caring for them, the hospital, their own incomes. This doubt is eroding trust, and inhibiting patient centred care.

Trust is central to all relationships and businesses and in the context of healthcare, which is characterised by vulnerability, it is even more so. In a doctor patient relationship, trust stems from the patient’s belief that the doctor is their ally and is competent in both clinical and interpersonal skills; and that his medical needs will be kept paramount by the doctor, and above all other considerations.

Trust as a construct in healthcare is complicated and multidimensional. As per the research done by Thom and Campbell, we know there are nine dimensions of trust which we can bucket into three broad categories: Technical competence, Interpersonal skills and Organisational factors. Features that influence trust are: Physician behaviour, Patient attributes and Organisational behaviour. More the overlap between these three, greater the level of trust.

Physician attributes that are known to impact trust positively are Competence, Compassion, Privacy, Confidentiality, Reliability, Dependability and Communication. Over two thousand years ago, the Hippocratic Oath originally outlined trust building behaviour for physicians recognising how critical it was for the healing process. The sustained use of Oath reflects how profoundly important physician behaviour is for building patient physician trust.