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.
Key words patients’ trust - choice of physician - patient-physician relationship - physician payment method
This work was funded by the Prudential Center for Health Care Research. During the conduct of this study, Dr. Cleary was a
consultant to the Prudential Center for Health Care Research. The authors thank Barbara McNeil, MD, PhD, and Carol McPhillips-Tangum,
MPH, for their helpful comments on the study, Sean Lee for data programming, and Linda Emanuel, MD, PhD, for her review of
the manuscript.