Why Physicians Should Trust in Patients

Grob, Rachel; Darien, Gwen; Meyers, David

doi:10.1001/jama.2019.1500

Cited by 32 publications

(34 citation statements)

References 8 publications

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“…At the system level, patient-centeredness requires a healthcare system that considers and addresses the social determinants of health and is persistent in its efforts to support older adults. Older adults and caregivers both indicated that trust from the system and its providers is essential for ensuring that they receive appropriate care, but also, for fostering shared decision-making, strengthening partnerships, and improving quality of care as defined in multiple ways ( Grob et al, 2019 ). Similarities in themes emerging from the two types of focus groups suggest a need for greater exploration of caregivers’ role in healthcare decisions for or with their older relatives ( Dalton, 2003 ; Rabow et al, 2004 ; Reinhard et al, 2008 ; Rodakowski et al, 2017 ).…”

Section: Discussionmentioning

confidence: 99%

What Does “Patient-Centered” Mean? Qualitative Perspectives from Older Adults and Family Caregivers

Raj

Platt

Anthony

et al. 2021

Gerontology and Geriatric Medicine

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This study aimed to (1) examine what patient-centeredness means for older adults and family caregivers, and (2) assess circumstances underlying their preference for geriatric care. We conducted separate focus groups with older adults and family caregivers of older adults about health care experiences and expectations and conducted a vignette-based experiment to assess preference for geriatric care. Participants expressed a need for greater skill and empathy and integration of caregivers. They preferred geriatric care to usual primary care with increasing social, health, and healthcare complexity. Distinct needs of older adults should be considered in referral practices to geriatric medicine.

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Section: Discussionmentioning

confidence: 99%

What Does “Patient-Centered” Mean? Qualitative Perspectives from Older Adults and Family Caregivers

Raj

Platt

Anthony

et al. 2021

Gerontology and Geriatric Medicine

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“…The 2019 JAMA viewpoint series discusses trust from multiple perspectives within the health system. Trust is needed between (1) patient and physician (1), (2) between clinicians and their organizations (2), as well as (3) between clinicians and the governments who often finance health care (3). The series also explores how building trust in health systems can help eliminate health disparities (4).…”

Section: Introductionmentioning

confidence: 99%

“…Trust is also necessary for collaborative decision making and essential for effective and sustainable partnerships (18,19). At a global level, effective trust building in health systems requires accountability to citizens and incorporation of their voices in policies that affect them (1,2,15,20).…”

Section: Introductionmentioning

confidence: 99%

Trust is the engine of change: A conceptual model for trust building in health systems

Adam

Donelson²

2020

Preprint

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Background: Physicians, health care organizations, governments and communities are increasingly interested in how trust is built throughout the health system. Current science on building trust draws on diverse literature from business and consumer science to healthcare, and theory development has predominately focused on factor based models. We propose a process based theoretical model for trust building which may better reflect the complex and dynamic nature of trust itself. In doing so, we propose a new measurable dimension of the trust building process: reciprocity cycles. Cooperative reciprocal relationships are its building blocks, enabling stakeholders to “try out” their interactions with less risk, and to calibrate their level of effort, time and emotional investment. Reciprocity cycles includes three measurable elements: common goals, self-interests and gratitude/indebtedness.Methods: We applied the model, developing outcomes and measures in close-to-community health partnerships in Kenya. A 3-day workshop designed to stimulate problem solving and collaborative teamwork using human centered design principles was offered in 2 community health units in diverse contexts (rural agrarian and peri-urban flower farm slum), each with about 30 community health volunteers (CHVs) serving a population of approximately 5,000. Each unit formed separate teams representing specific villages; we followed these 9 teams between 18 to 24 months.Results: All 9 volunteer CHV teams delivered on self-directed public health outcomes across the spectrum of social determinants of health over the follow up period, with no funding, only using their own locally available resources. Projects were diverse, including immunization, composting toilets, hygiene, neonatal and reproductive health and public gardening. All 9 teams demonstrated trust building reciprocity cycles with articulation of common goal, self-interest, and gratitude/indebtedness. Conclusion: A process model of trust building, defined by reciprocity cycles, can be stimulated with a short intervention (illustrated here in close-to-community health systems) resulting in trusting relationships that drive agency and co-production of positive outcomes for health systems. In addition, it offers a simpler, more useful framework for trust building and measurement than traditional models of trust in health systems research. Early findings illustrate reciprocity cycles are scalable and adaptable, with potential utility at multiple levels of health systems.

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“…a) The fMRI hyperscanning environment. The clinician (1) and patient (2) were positioned in two different 3T MRI scanners. An audio-video link enabled on-line communication between the two scanners (3), and video images were used to frameby-frame facial expression metrics.…”

mentioning

confidence: 99%

Dynamic brain-to-brain concordance and behavioral mirroring as a mechanism of the patient-clinician interaction

Ellingsen

Isenburg

Jung

et al. 2020

Preprint

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The patient-clinician interaction can powerfully shape treatment outcomes such as pain, but is often considered an intangible “art-of-medicine”, and has largely eluded scientific inquiry. Although brain correlates of social processes such as empathy and theory-of-mind have been studied using single-subject designs, the specific behavioral and neural mechanisms underpinning the patient-clinician interaction are unknown. Using a two-person interactive design, we simultaneously recorded functional MRI (i.e. hyperscanning) in patient-clinician dyads, who interacted via live video while clinicians treated evoked pain in chronic pain patients. Our results show that patient analgesia is mediated by patient-clinician nonverbal behavioral mirroring and brain-to-brain concordance in circuitry implicated in theory-of-mind and social mirroring. Dyad-based analyses showed extensive dynamic coupling of these brain nodes with the partners’ brain activity, yet only in dyads where clinical rapport had been established prior to the interaction. These findings point to a putatively key brain-behavioral mechanism for therapeutic alliance and psychosocial analgesia.

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Why Physicians Should Trust in Patients

Cited by 32 publications

References 8 publications

What Does “Patient-Centered” Mean? Qualitative Perspectives from Older Adults and Family Caregivers

What Does “Patient-Centered” Mean? Qualitative Perspectives from Older Adults and Family Caregivers

Trust is the engine of change: A conceptual model for trust building in health systems

Dynamic brain-to-brain concordance and behavioral mirroring as a mechanism of the patient-clinician interaction

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