Trust in doctor-patient relationships

Trust in doctor-patient relationships and the Social penetration theory Angella Giannacopoulos The Pennsylvania State University

Trust in doctor-patient relationships Abstract

This paper explores the importance of trust in doctor-patient relationships and how it can make a difference in overall quality of care. Social penetration theory is then defined and applied to the problem to help understand how this theory is already forced upon us and how crucial penetration, mutual self disclosure and reciprocation are in order to reassure and gain trust. This paper examines how greater treatment success can be guaranteed once trust is earned. Finally, this paper will offer useful solutions on how to form and maintain a trusting doctor-patient relationship. Keywords: trust, doctor-patient relationship, social penetration theory

Trust in doctor-patient relationships Although trust can be difficult to attain, it is a crucial factor to a successful and comfortable doctor-patient relationship. It has been hypothesized or shown to affect a host of important behaviors and attitudes, including patients willingness to seek care, reveal sensitive information, submit to treatment, participate in research, adhere to treatment regimens, remain with a physician, and recommend physicians to others. In addition, it may mediate clinical

outcomes (Dugan, Hall, Mishra, Zheng 614). Being able to trust ones doctor has been shown to make a difference in overall quality of care and is, therefore, a good way to reassure a patient that he is in good hands. When there is no communication between a doctor and his or her patient it may make the patient believe that the doctor has no true interest in the patient and solely cares for the matter at hand. In cases such like this, patients reported that they were not encouraged to ask questions, not asked their opinions about ailments and treatments, and were not given advice on lifestyle changes that could positively affect their health (Chin, 580). Social penetration theory was developed by Irwin Altman and Dalmas Taylor to explain and better understand how relational closeness develops. The theory explains the process of developing deeper intimacy with another person through mutual self-disclosure and other forms of vulnerability (Griffin, 2012). Altman and Dalmas made the comparison of people to onions. According to the text, social penetration theory can be used to describe the multilayered structure of personality (Griffin, 2012). Peel the outer skin from an onion, and youll find another beneath it. Remove that layer and youll expose a third, and so on (Griffin, 2012). The same holds true for people; as we get to know someone better we are either exposed to multiple layers of their personality and are closer to the individual or are shut out and never get to peel the onion. Altman and Taylor go on to say that in order for people to develop close and meaningful relationships, penetration must occur and that the depth of penetration is crucial and

Trust in doctor-patient relationships will ultimately determine the degree of intimacy (Griffin, 2012). This process of penetration requires reciprocation and mutual self-disclosure in order to be successfully achieved. Many people naturally use the social penetration theory and are unaware because it is part of how humans interact with one another. We either keep private and to ourselves, or release certain information depending on our vulnerability and the risk we take to be peeled down to our deepest core. For doctor-patient relationship, the brief and perfunctory consultations fail to provide sufficient time for the development of a familiarity that strengthens a relationship (Chin, 580).

Average people typically visit a doctor between one and two times a year making it even more of a challenge to form an actual trusting relationship. In order for a doctor to treat his or her patient properly, he or she must know the necessary information. Any previous health issues, any conditions the patient may have, any psychological issues the patient may be facing, and even any personal information that may seem embarrassing such as intimate relations with others, are all sometimes necessary information doctors must know. When personal, hard to share yet necessary information is left out, and penetration does not occur, and patients are only harming themselves as the doctor is not being informed about information that could potentially be crucial to treatment. Therefore, patients, are often forced more deeply into the onion. One must share certain information to receive treatment from the doctor; the omission of any information may ultimately affect the possibility for successful treatment and recovery. Reciprocation and mutual self-disclosure are necessary in a doctor-patient relationship in order for trust to be gained. The doctor and patient together must negotiate how and what will be communicated during the exam to insure greater satisfaction (Arnold, Miller-Day, Walker, Webb 15).

Trust in doctor-patient relationships By discussing ahead of time what needs to be addressed during a visit and how it will be addressed will ensure the patient that the doctor is indeed interested in the patients needs, ensuring later trust in their relationship, and, ultimately, greater treatment success. The level of

trust in ones physician has been shown to correlate closely and independently with satisfaction with physician and adherence to treatment (Arnold, Miller-Day, Walker, Webb 18). Doctors and patients must be open with one another and doctors should give patients an opportunity to divulge. The doctor-patient relationship must be a two-way street. Not only the patient, but the doctor as well, must share information with the patient to make him or her feel comfortable to share information back. For example, if the doctor can relate to personally, or through a family member, a certain situation his patient is going through he may want to disclose his experience to let the patient feel more comfortable. For instance, maybe a patient has asthma and is scared. If the doctor has a child who has asthma he may want to share that information with his patient to reassure his patient that he understands why he or she may be scared. Trust is important because it allows people more freedom in disclosing personal information. In particular, health research by communication scholars and clinicians clearly demonstrated that patients who have trusting relationships with their physicians have better health outcomes (Arnold, Miller-Day, Walker, Webb 20).

Trust in doctor-patient relationships References Arnold, C.L., Miller-Day, Michelle, Walker, K.L., Webb, L.M. (2001). Investigating the PhysicianPatient Relationship: Examining Emerging Theme. Health Communication, 14(1), 4568. Chin, JJ. Doctor-Patient Relationship: A Covenant of Trust. Singapore Medical Journal, 42(12), 579-581 Dugan, E., Hall, M. A., Mishra, A. K., and Zheng, B. (2001). Trust in Physicians and Medical Institutions: What Is It, Can It Be Measured, and Does It Matter?. Milbank Quarterly, 79, 613639. Griffin, E. (2012). A first look at communication theory (8th ed). New York: McGraw-Hill.