General Practitioners' Trust in Their Patients: A Qualitative Study.

Abstract

Mutual trust is a critical component of the physician-patient relationship, and although much research has examined patient trust in the physician, little attention has been given to the physician's trust in the patient in the general practice setting. This study explored general practitioners' (GPs') understanding of trust in their patients. We conducted a qualitative study using semistructured telephone interviews with a convenience sample of Australian GPs mostly from metropolitan New South Wales, focused on how the GPs understood trust in their patients, how such trust developed, and its implications for medical care. Interviews were audio recorded, transcribed verbatim, verified, and de-identified before thematic analysis. Qualitative analysis was based on interviews with 25 GPs. We identified 3 main themes pertaining to GPs' trust in their patients: (1) trusting patients is an assumed starting point, (2) trust in patients then deepens and develops over time as part of a mutual trusting therapeutic relationship, and (3) trust in their patients is challenged when patients are perceived to be manipulating the relationship for secondary gain. Our study shows that GPs understand a therapeutic relationship with a patient begins by trusting what their patients say, then develops as their patients become more actively involved in their own management. GPs need support in building mutually trusting relationships, especially in patients with complex care needs.