A Model of Interpersonal Trust, Credibility, and Relationship Maintenance.

Abstract

> I wasn’t upset by my child’s bad reaction to the treatment. I was upset because no one told me it was a possibility beforehand. > I don’t think our doctor looked at us during the entire visit. She just kept typing away. > I couldn’t get in touch with my child’s medical team for three days after the scans. I just had to sit around and worry until the nurse finally returned my calls. Trust is essential to the clinician-family relationship in pediatrics, and it is affected by the actions or inactions of clinicians. High levels of trust can support confidence, peace of mind, and a sense of security. Broken trust can lead to anxiety, second-guessing, and frustration. In these opening statements, parents describe lapses in clinicians’ honesty, fidelity, and caring that impaired their trust. Mounting evidence suggests that the US health care system is entering into a crisis of trust, with Americans reporting decreased trust in physicians and the health care system over the last half century.1 In 2014, a report found that only 58% of American patients agreed that doctors could be trusted, ranking 24th among all countries surveyed.1 Lee et al2 argued that this erosion of trust has resulted from the deprioritization of relationships in modern US health care, and they recommended a framework for increasing trust between patients and health care organizations or health care teams. Although this organizational trust is important, we argue that interpersonal trust in pediatrics between each family and clinician is paramount. Every clinician has an opportunity … Address correspondence to Bryan Sisk, MD, Department of Pediatrics, Washington University School of Medicine, 4523 Clayton Ave, Campus Box 8005, St Louis, MO 63110. E-mail: siskb{at}wustl.edu