Skip to main content

Advertisement

Log in

The Import of Trust in Regular Providers to Trust in Cancer Physicians among White, African American, and Hispanic Breast Cancer Patients

  • Original Research
  • Published:
Journal of General Internal Medicine Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Calnan M, Rowe R. Researching trust relations in health care. J Organisat Manag. 2006;20(5):349–58.

    Article  Google Scholar 

  2. Hall MA, et al. Trust in physicians and medical institutions: what is it, can it be measured, and does it matter? Milbank Q. 2001;79(4):613–39.

    Article  CAS  PubMed  Google Scholar 

  3. Safran, D.G., et al. Linking primary care performance to outcomes of care. J Fam Pract, 1998. v47(n3): p 213(8).

  4. Kraetschmer N, et al. How does trust affect patient preferences for participation in decision-making? Health Expect. 2004;7(4):317–26.

    Article  PubMed  Google Scholar 

  5. Piette JD, et al. The role of patient-physician trust in moderating medication nonadherence due to cost pressures. Arch Intern Med. 2005;165(15):1749–55.

    Article  PubMed  Google Scholar 

  6. Altice FL, Mostashari F, Friedland GH. Trust and the acceptance of and adherence to antiretroviral therapy. J Acquir Immune Defic Syndr. 2001;28(1):47–58.

    CAS  PubMed  Google Scholar 

  7. Schneider J, et al. Better physician-patient relationships are associated with higher reported adherence to antiretroviral therapy in patients with HIV infection. J Gen Intern Med. 2004;19(11):1096–103.

    Article  PubMed  Google Scholar 

  8. Mostashari F, et al. Acceptance and adherence with antiretroviral therapy among HIV-infected women in a correctional facility. J Acquir Immune Defic Syndr Human Retrovirol. 1998;18:341–8.

    CAS  Google Scholar 

  9. Safran DG, et al. Switching doctors: predictors of voluntary disenrollment from a primary physician’s practice. J Fam Pract. 2001;50(2):130–6.

    CAS  PubMed  Google Scholar 

  10. Thom DH, et al. Patient trust in the physician: relationship to patient requests. Fam Pract. 2002;19(5):476–83.

    Article  PubMed  Google Scholar 

  11. Ahmed NU, et al. Empowering factors for regular mammography screening in under-served populations: pilot survey results in tennessee. Ethn Dis. 2005;15(3):387–394.

    PubMed  Google Scholar 

  12. Sheppard V, et al. Are health-care relationships important for mammography adherence in latinas? J Gen Intern Med. 2008;23(12):2024–30.

    Article  PubMed  Google Scholar 

  13. O'Malley AS, et al. The role of trust in use of preventive services among low-income African-American women. Prev Med. 2004;38(6):777–85.

    Article  PubMed  Google Scholar 

  14. Lansdown M, Martin L, Fallowfield L. Patient-physician interactions during early breast-cancer treatment: results from an international online survey. Curr Med Res Opin. 2008;24(7):1891–904.

    Article  CAS  PubMed  Google Scholar 

  15. Penman DT, et al. Informed consent for investigational chemotherapy: patients' and physicians' perceptions. J Clin Oncol. 1984;2(7):849–55.

    CAS  PubMed  Google Scholar 

  16. Mainous AG III, et al. The relationship between continuity of care and trust with stage of cancer at diagnosis. Fam Med. 2004;6(1):35–9.

    Google Scholar 

  17. Starfield B, Shi L, Macinko J. Contribution of primary care to health systems and health. Milbank Q. 2005;83(3):457–502.

    Article  PubMed  Google Scholar 

  18. Hickner J, et al. Physicians' and patients' views of cancer care by family physicians: a report from the american academy of family physicians national research network. Fam Med. 2007;39(2):126–31.

    PubMed  Google Scholar 

  19. Bulsara C, Ward AM, Joske D. Patient perceptions of the GP role in cancer management. Aust Fam Physician. 2005;34(4):299–300.

    PubMed  Google Scholar 

  20. Klabunde C, et al. The role of primary care physicians in cancer care. J Gen Intern Med. 2009;24(9):1029–36.

    Article  PubMed  Google Scholar 

  21. Keating N, et al. Patient Characteristics and experiences associated with trust in specialist physicians. Arch Intern Med. 2004;164:1015–20.

    Article  PubMed  Google Scholar 

  22. Grumbach K, et al. Resolving the gatekeeper conundrum: what patients value in primary care and referrals to specialists. JAMA. 1999;282(3):261–6.

    Article  CAS  PubMed  Google Scholar 

  23. Boulware LE, et al. Race and trust in the health care system. Public health reports (Washington, DC: 1974), 2003. 118(4): p 358-365.

  24. Gordon HS, et al. Racial differences in trust and lung cancer patients' perceptions of physician communication. J Clin Oncol. 2006;24(6):904–9.

    Article  PubMed  Google Scholar 

  25. Halbert CH, et al. Racial differences in trust in health care providers. Arch Intern Med. 2006;166(8):896–901.

    Article  PubMed  Google Scholar 

  26. Masi C, Gehlert S. Perceptions of breast cancer treatment among african-american women and men: implications for interventions. J Gen Intern Med. 2009;24(3):408–14.

    Article  PubMed  Google Scholar 

  27. Balkrishnan R, et al. Trust and satisfaction with physicians, insurers, and the medical profession. Med Care. 2003;41(9):1058–64. doi:10.1097/01.MLR.0000083743.15238.9F.

    Article  PubMed  Google Scholar 

  28. Shenolikar R, Balkrishnan R, Hall M. How patient-physician encounters in critical medical situations affect trust: results of a national survey. BMC Health Serv Res. 2004;4(1):24.

    Article  PubMed  Google Scholar 

  29. Mechanic D, Meyer S. Concepts of trust among patients with serious illness. Soc Sci Med. 2000;51(5):657–68.

    Article  CAS  PubMed  Google Scholar 

  30. Thom DH, Hall MA, Pawlson LG. Measuring patients' trust in physicians when assessing quality of care. Health Aff. 2004;23(4):124–32.

    Article  Google Scholar 

  31. Haywood C, et al. The association of provider communication with trust among adults with sickle cell disease. J Gen Intern Med. 2010;25(6):543–8.

    Article  PubMed  Google Scholar 

  32. Cooper LA, et al. Patient-centered communication, ratings of care, and concordance of patient and physician race. Ann Intern Med. 2003;139(11):907–15.

    PubMed  Google Scholar 

  33. Bowles EJA, et al. Understanding high-quality cancer care. Cancer. 2008;112(4):934–42.

    Article  Google Scholar 

  34. Jacobs EA, et al. Understanding African Americans' views of the trustworthiness of physicians. J Gen Intern Med. 2006;21(6):642–7.

    Article  PubMed  Google Scholar 

Download references

Acknowledgement

This work was funded by the National Cancer Institute (Grant no. 5 P50 CA 106743) to the University of Illinois at Chicago Center for Population Health and Health Disparities, National Institutes of Health Grants R01 AG033172-01 and 1R21HD057473-01A1, and National Cancer Institute Training Program R25TCA57699-14. This work was presented at the annual meeting of the American Society of Preventive Oncology, March 2010.

Conflicts of interest

None disclosed.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Karen Kaiser PhD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kaiser, K., Rauscher, G.H., Jacobs, E.A. et al. The Import of Trust in Regular Providers to Trust in Cancer Physicians among White, African American, and Hispanic Breast Cancer Patients. J GEN INTERN MED 26, 51–57 (2011). https://doi.org/10.1007/s11606-010-1489-4

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11606-010-1489-4

KEY WORDS

Navigation