Trust and vulnerability in doctor-patient relations in occupational health

Plomp, H.N.; Ballast, N.

doi:10.1093/occmed/kqq067

Cited by 29 publications

(16 citation statements)

References 12 publications

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“…There were differences between trust in physicians from different specialties (for example, higher for cardiologists than for general internists; [60]). Furthermore, the nature of the disorder and its severity play a role for trust in physicians: in a Dutch academic setting, the urgency or threat of vulnerability (defined as current reported poor health, high workload, and high absenteeism) explained the relationship between trust and vulnerability [50]. Also, ethnicity plays a role.…”

Section: Resultsmentioning

confidence: 99%

EPA Guidance on Building Trust in Mental Health Services

et al. 2014

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Section: Resultsmentioning

confidence: 99%

EPA Guidance on Building Trust in Mental Health Services

et al. 2014

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“…Negative and/or sterotypical group perecptions have been reported in other studies: For example RPs being unaware of the OP’s role and function in rehabilitation [ 7 , 8 , 10 , 13 , 59 ]; patient unawareness of of the existence of OPs or their function, as well as patient mistrust of OPs as barriers to cooperation in the rehabilitation process [ 4 , 7 , 12 , 27 , 60 – 62 ]; or a lack of understanding of the OP’s role among physicians [ 19 , 61 , 63 ]. Several studies mention PCPs [ 14 – 18 , 20 , 59 , 64 , 65 ] or RPs [ 8 , 9 ] mistrusting OPs (e.g.…”

Section: Discussionmentioning

confidence: 99%

Image and perception of physicians as barriers to inter-disciplinary cooperation? – the example of German occupational health physicians in the rehabilitation process: a qualitative study

Stratil

Rieger

Voelter-Mahlknecht

2018

BMC Health Serv Res

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BackgroundIn the German rehabilitation system, primary care physicians (PCPs), occupational health physicians (OPs), and rehabilitation physicians (RPs) fulfill different distinct functions and roles. While effective cooperation can improve outcomes of rehabilitation, the cooperation between these groups of stakeholders has been criticized as lacking or insufficient. This article proposes an approach to understand the low levels of cooperation by examining the role of group perception and group identity in intra-professional cooperation as a barrier to cooperation between physicians in different roles. Group perception was evaluated in terms of (1) negative views about another group of medical specialists and (2) differences between the perception of members and non-members of a medical specialty group. To examine this issue, we focused on the role of OPs in the German rehabilitation process.MethodsWe implemented a qualitative study design with eight focus group discussions with PCPs, OPs, RPs, and patients (two focus group discussions per stakeholder group; 4–10 participants) and qualitative content analysis. We used the Social Identity Approach by Tajfel and Turner as a theoretical underpinning.ResultsWhile all protagonists reported a positive perception of their own professional group, we found numerous negative perceptions about other groups, especially regarding OPs. Negative perceptions of OPs included 1) apparent conflict of interest between employer and employee, 2) lack of commitment to patient outcomes, 3) lack of useful specialized knowledge which could have a bearing on rehabilitation outcomes, and 4) distrust on the part of their patients. We also found divergent perceptions regarding roles, responsibilities, and capabilities among the specialist groups. Both negative and conflicting perceptions about roles were characterized as barriers to cooperation by study participants.ConclusionThis example of cooperation between RPs, OPs, and PCPs suggests that negative and diverging perceptions about an out-group could create barriers in intra-professional and inter-disciplinary cooperation between physicians. These perspectives might also be useful in explaining problems at intersections between different specialties. We suggest examining the inter-group dimension of perception-based barriers to cooperation in future interventions to overcome problems caused by intra-professional and inter-disciplinary conflicts in addition to other barriers (i.e. organizational hurdles).Electronic supplementary materialThe online version of this article (10.1186/s12913-018-3564-1) contains supplementary material, which is available to authorized users.

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“…They felt taken seriously by the care manager and occupational therapist, and they rated them with high marks. The issue of trust in an occupational physician has been documented before [ 36 ]. Although the care manager who delivered the intervention in our study was not linked to the employers of our patients, and hence was independent, our patients still had concerns about trust and confidentiality of the care manager.…”

Section: Discussionmentioning

confidence: 99%

Process Evaluation of a Workplace Integrated Care Intervention for Workers with Rheumatoid Arthritis

et al. 2016

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Purpose To perform a process evaluation of the implementation of a workplace integrated care intervention for workers with rheumatoid arthritis to maintain and improve work productivity. The intervention consisted of integrated care and a participatory workplace intervention with the aim to make adaptations at the workplace. Methods The implementation of the workplace integrated care intervention was evaluated with the framework of Linnan and Steckler. We used the concepts recruitment, reach, dose delivered, dose received, fidelity and satisfaction with the intervention. Data collection occurred through patient questionnaires and medical records. Results Participants were recruited by sending a letter including a reply card from their own rheumatologist. In total, we invited 1973 patients to participate. We received 1184 reply cards, and of these, 150 patients eventually participated in the study. Integrated care was delivered according to protocol for 46.7 %, while the participatory workplace intervention was delivered for 80.6 %. Dose received was nearly 70 %, which means that participants implemented 70 % of the workplace adaptations proposed during the participatory workplace intervention. The fidelity score for both integrated care and the participatory workplace intervention was sufficient, although communication between members of the multidisciplinary team was limited. Participants were generally satisfied with the intervention. Conclusions This process evaluation shows that our intervention was not entirely implemented as intended. The integrated care was not delivered to enough participants, but for the intervention components that were delivered, the fidelity was good. Communication between members of the multidisciplinary team was limited. However, the participatory workplace intervention was implemented successfully, and participants indicated that they were satisfied with the intervention.

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Trust and vulnerability in doctor-patient relations in occupational health

Abstract: Trust and the need for trust vary with the character and severity of ill health. Studies on trust in doctor-patient relationships are more worthwhile if they are directed at specific groups and situations.

Cited by 29 publications

References 12 publications

EPA Guidance on Building Trust in Mental Health Services

EPA Guidance on Building Trust in Mental Health Services

Image and perception of physicians as barriers to inter-disciplinary cooperation? – the example of German occupational health physicians in the rehabilitation process: a qualitative study

Process Evaluation of a Workplace Integrated Care Intervention for Workers with Rheumatoid Arthritis

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