Do your patients trust you?: A sociological understanding of the implications of patient mistrust in healthcare professionals

Samantha Meyer

doi:10.4066/amj.2008.7

Abstract

The trust that patients invest in healthcare professionals and their advice has been shown to facilitate positive clinical outcomes, although there is evidence that patient trust in expertise, including healthcare professionals, has been declining over the years. Questions about whether or not to trust healthcare professionals have been raised recently in international media by Australian pop icon Kylie Minogue, who spoke of her alleged initial misdiagnosis with breast cancer and went on to tell women that they should ‘follow their intuition’ rather than placing unquestioning trust in doctors or medical advice. Given the power of the media in shaping public opinion, there is a potential for such stories to further impact on the already potentially friable doctor-patient relationships, with questions of trust taking centre-stage. Therefore, an understanding of the nature of trust, in addition to the reasons for the decline in patient trust, is exceedingly important for health professionals. This paper presents an overview of social theories of trust that provide a lens through which we can analyse the development of mistrust in healthcare, and identifies ways in which healthcare professionals may aim to facilitate and sustain patient trust.

Highlights

The trust that patients invest in healthcare professionals and their advice has been shown to facilitate positive clinical outcomes, there is evidence that patient trust in expertise, including healthcare professionals, has been declining over the years
The above quote was taken from an American talk show (The Ellen Degeneres Show, April 8, 2008)
Kylie appeared on Ellen in April of 2008 and shared her experience, giving the audience advice to ‘follow their intuition’ rather than making the assumption that their physician is always providing the right medical information

Summary

Introduction

The trust that patients invest in healthcare professionals and their advice has been shown to facilitate positive clinical outcomes, there is evidence that patient trust in expertise, including healthcare professionals, has been declining over the years. Questions about whether or not to trust healthcare professionals have been raised recently in international media by Australian pop icon Kylie Minogue, who spoke of her alleged initial misdiagnosis with breast cancer and went on to tell women that they should ‘follow their intuition’ rather than placing unquestioning trust in doctors or medical advice. Kylie appeared on Ellen in April of 2008 and shared her experience, giving the audience advice to ‘follow their intuition’ rather than making the assumption that their physician is always providing the right medical information. This ‘trust in intuition’ may be at odds with ‘trust in medical advice’ within the world of evidence-based medicine, and speaks to the difference between ‘experiential/lay knowledge’ and ‘expert/professional knowledge’.1. The increase in weekly screenings following publicity surrounding Kylie’s breast cancer diagnosis in 2005 supports the argument that the “utilization of health services is generally subsequent to the consumption of information” (p.1454);[6] often regardless of whether it is from potentially unreliable sources

Objectives

Findings

Conclusion