Hostname: page-component-78c5997874-lj6df Total loading time: 0 Render date: 2024-11-13T11:35:39.907Z Has data issue: false hasContentIssue false

Determinants of trust in the patient–oncologist relationship

Published online by Cambridge University Press:  25 October 2007

Nagashree Seetharamu*
Affiliation:
New York University Medical Center, New York, New York, USA
Uzma Iqbal
Affiliation:
Long Island Jewish Medical Center, New Hyde Park, New York, USA Albert Einstein College of Medicine, Bronx, New York, USA
Joseph S. Weiner
Affiliation:
Long Island Jewish Medical Center, New Hyde Park, New York, USA Albert Einstein College of Medicine, Bronx, New York, USA
*
Corresponding author: Joseph S. Weiner, North Shore University Hospital/Manhasset, 300 Community Drive, Manhasset, NY 11030, USA. E-mail: weiner@lij.edu

Abstract

Objective:

The relationship between the patient and physician is at the heart of good medical care, and trust is an essential component of this relationship. To enable the oncologist to better form a trusting relationship with the patient, this article describes four factors that influence patient trust.

Methods:

Thematic literature review and a clinical vignette.

Results:

The authors discuss four factors that influence patient trust. These factors are whether and how the oncologist (1) minimizes the potential for shame and humiliation during the medical encounter, (2) manages the power imbalance between doctor and patient without abuse or misuse, (3) demonstrates to the patient an appreciation of how he or she is suffering from experience of cancer, and (4) demonstrates to the patient how he or she is suffering from the treatment provided by the oncologist. The authors illustrate these factors with a clinical vignette.

Significance of results:

The cancer patient is best cared for by an oncologist who can not only understand disease and treat medical problems, but also accompany the patient through the illness experience. This requires an appreciation of the challenges to trust that are inherent in the special characteristics of the patient–physician interaction.

Type
Review Article
Copyright
Copyright © Cambridge University Press 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Berger, A.M., Portney, R.K., & Weissman, D.E. (2002). Principles and Practice of Palliative Care and Supportive Oncology. Philadelphia, PA: Lippincott, Williams & Wilkins.Google Scholar
Blackhall, L.J., Frank, G., Murphy, S.T., et al. (1999). Ethnicity and attitudes towards life sustaining technology. Social Science & Medicine, 48, 17791789.CrossRefGoogle ScholarPubMed
Caralis, P.V., Davis, B., Wright, K., et al. (1993). The influence of ethnicity and race on attitudes toward advance directives, life-prolonging treatments, and euthanasia. Journal of Clinical Ethics, 4, 155165.CrossRefGoogle ScholarPubMed
Cassel, E.J. (1982). The nature of suffering and the goals of medicine. New England Journal of Medicine, 306, 639645.CrossRefGoogle ScholarPubMed
Chapple, A., Ziebland, S., & McPherson, A. (2004). Stigma, shame, and blame experienced by patients with lung cancer: Qualitative study. British Medical Journal, 328, 14701473.CrossRefGoogle ScholarPubMed
Charles, C., Gafni, A., & Whelan, T. (1999). Decision-making in the physician–patient encounter: Revisiting the shared treatment decision-making model. Social Science & Medicine, 49, 651661.CrossRefGoogle ScholarPubMed
Crawley, L.M. (2005). Racial, cultural, and ethnic factors influencing end-of-life care. Journal of Palliative Medicine, 8 (Suppl. 1), s5869.CrossRefGoogle ScholarPubMed
Emanuel, E.J. & Dubler, N.N. (1995). Preserving the physician–patient relationship in the era of managed care. JAMA, 273, 323329.CrossRefGoogle ScholarPubMed
Farber, N., Novack, D., & O'Brien, M. (1997). Love, boundaries, and the patient–physician relationship. Archives of Internal Medicine, 157, 22912294.CrossRefGoogle ScholarPubMed
Gabbard, G.O. (1995). Countertransference: The emerging common ground. International Journal of Psychoanalysis, 76, 475–85.Google ScholarPubMed
Kao, A.C., Green, D.C., Zaslavi, A.M., et al. (1998). The relationship between method of physician payment and patient trust. JAMA, 280, 17081714.CrossRefGoogle ScholarPubMed
Keating, N.L., Gandhi, T.K., Orav, E.J., et al. (2004). Patient characteristics and experiences associated with trust in specialist physicians. Archives of Internal Medicine, 164, 10151020.CrossRefGoogle ScholarPubMed
Koenig, B.A. (1997). Cultural diversity in decision-making about care at the end of life. In Approaching Death: Improving Care at the End of Life, Field, M.J. & Cassel, C.K. (eds.), pp. 363382. Washington, DC: National Academic Press.Google Scholar
Krakauer, E.L., Crenner, C. & Fox, K. (2002). Barriers to optimum end-of-life care for minority patients. Journal of the American Geriatrics Society, 50, 182190.CrossRefGoogle ScholarPubMed
Lazare, A. (1987). Shame, humiliation, and stigma in the medical interview. Archives of Internal Medicine, 147, 16531658.CrossRefGoogle Scholar
Lochman, J.E. (1983). Factors related to patients' satisfaction with their medical care. Journal of Community Health, 9, 91109.CrossRefGoogle ScholarPubMed
Mechanic, D. & Meyer, S. (2000). Concepts of trust among patients. Social Science & Medicine, 51, 657668.CrossRefGoogle ScholarPubMed
Pearson, S.D. & Raeke, L.H. (2000). Patients' trust in physicians: Many theories, few measures, and little data. Journal of General Internal Medicine, 15, 509513.CrossRefGoogle ScholarPubMed
Thom, D.H. & Campbell, B. (1997). Patient-physician trust: An exploratory study. Journal of Family Practice, 44, 169176.Google ScholarPubMed
Weiner, J.S. (1996). Is depression inevitable in the face of AIDS? The AIDS Reader, 6, 6672.Google Scholar
Weiner, J.S., Gordon, J.H., Walerstein, S.J., et al. (2001). Program in the Patient–Doctor Relationship at Long Island Jewish Medical Center: Recipient of the Alan Stoudemire Award for Innovation and Excellence in Consultation-Liaison Education. Poster presentation, The Academy for Psychosomatic Medicine Annual Meeting.Google Scholar
Weiner, J.S. & Roth, J. (2006). Avoiding iatrogenic harm to patient and family while discussing goals of care near the end of life. Journal of Palliative Medicine, 9, 451463.CrossRefGoogle ScholarPubMed
Working Party of the Royal College of Physicians. (2005). Doctors in society. Medical professionalism in a changing world. Clinical Medicine, 6, 712.Google Scholar