Do emergency physicians trust their patients?

Abstract

The primary focus of research on the physician-patient relationship has been on patients' trust in their physicians. In this study, we explored physicians' trust in their patients. We held semi-structured interviews with expert emergency physicians concerning a patient they had just been managing. The physicians had been equipped with a head-mounted micro camera to film the encounter from an "own point of view perspective". The footage was used to stimulate recall during the interviews. Several participants made judgments on the reliability of their patients' accounts from the very beginning of the encounter. If accounts were not deemed reliable, participants implemented a variety of specific strategies in pursuing their history taking, i.e. checking for consistency by asking the same question at several points in the interview, cross-referencing information, questioning third-parties, examining the patient record, and systematically collecting data held to be objective. Our study raises the question of the influence of labeling patients as "reliable" or "unreliable" on their subsequent treatment in the emergency department. Further work is necessary to examine the accuracy of these judgments, the underlying cognitive processes (i.e. analytic versus intuitive) and their influence on decision-making.

Trust in older persons: A quantitative analysis of alignment in triads of older persons, informal carers and home care nurses

“…Their assessment could be based on two dimensions of trust that are similar to a person's assessment of trust in their care provider (Hall et al, ). These two dimensions are as follows: honesty (persons expressing benign motives, acting cooperatively and describing situations without exaggeration or ignoring relevant facts) and competence (assertiveness, compliance with directives and identifying and providing relevant information) (Kramer & Cook, ; Pelaccia et al, ; Rogers, ). Therefore, the care providers in this study could have picked up on non‐verbal cues in their daily interactions with an older person, which could explain their level of trust in that person.…”

“…One could argue that it is desirable to align the care provider's trust and the older person's view of their own trustworthiness. Research by Pelaccia and colleagues () shows that some formal care providers label certain older persons as ‘unreliable’ and trust them less because, for example, they do not think they are being sincere or honest in answering questions, whereas the older persons feel that they are.…”

“…Trust is a keystone in triads of older persons, informal carers and formal care providers (Hall, Zheng, et al, 2002;LoCurto & Berg, 2016;Pelaccia et al, 2016;Thorne & Robinson, 1988;Wiechula et al, 2016). It is closely related to other important aspects of relationships such as satisfaction, communication and privacy (Hall, Dugan, Zheng, & Mishra, 2001).…”

A Novel Approach to Study Medical Decision Making in the Clinical Setting: The “Own‐point‐of‐view” Perspective

“…30,37,38,41,42,50 Clinical Setting, Data Collection, and Data Analysis We carried out our research in three hospitals: a hospital in the region of Paris (France), a university hospital in a large French city, and a nonuniversity hospital in a medium-sized French city. Five physicians were enrolled in each place to reach data saturation.…”

Troisième Conférence internationale de Montréal sur le raisonnement clinique : une pluralité de perspectives pour des enjeux partagés

“…En l'occurrence, le contexte social qui inclut les collègues, les autres professionnels et le patient, affecte la manière dont le professionnel raisonne. En effet, des résultats de recherche montrent que les médecins urgentistes donnent plus ou moins d'importance aux données provenant des autres professionnels et des patients en fonction de leurs jugements a priori sur la crédibilité de ces personnes [4] . Les médecins utilisent en quelque sorte des « filtres » qui trient les données à la source, au tout début de leur processus de raisonnement clinique.…”