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Trust and Satisfaction With Physicians, Insurers, and the Medical Profession

Balkrishnan, Rajesh PhD*; Dugan, Elizabeth PhD; Camacho, Fabian T. MS; Hall, Mark A. JD

doi: 10.1097/01.MLR.0000083743.15238.9F
Original Articles

Background.  Conceptual or theoretical analysts of trust in medical settings distinguish among markedly different objects or types of trust. However, little is known about how similar or different these types of trust are in reality and the relationship of trust with satisfaction.

Objectives.  This exploratory study conducted a comparison among trust in one’s personal physician, health insurer, and in the medical profession, and examined whether the relationship between trust and satisfaction differs according to the type of trust in question.

Research Design.  Random national telephone survey using validated multi-item measures of trust and satisfaction.

Subjects.  A total of 1117 individuals aged 20 years and older with health insurance and reporting 2 healthcare professional visits in the past 2 years.

Results.  Rank-order correlation analyses find that both physician and insurer trust are sensitive to the amount of contact the patient has had and their adequacy of choice in selecting the physician or insurer. Trust in the medical profession stands out as being uniquely related to patients’ desire to seek care and their preference for how much control physicians should have in making medical decisions. Adding satisfaction to the models reduced the number of significant predictors of insurance trust disproportionately.

Conclusions.  Consistent with theory, we found both substantial similarities and notable differences in the sets of factors that predict 3 different types of trust. Trust and satisfaction are much less distinct with respect to health insurers than with respect to physicians or the medical profession.

From the *Department of Management and Policy Sciences, University of Texas, School of Public Health, Houston, Texas.

From †New England Research Institutes, Watertown, Massachusetts.

From the ‡Department of Public Health Sciences, Wake Forest University Health Sciences, Winston-Salem, North Carolina.

This study was supported by a grant from the Robert Wood Johnson Foundation.

Address correspondence and reprint requests to Rajesh Balkrishnan, PhD, Associate Professor, University of Texas, School of Public Health, Department of Management and Policy Sciences, PO Box 20186, 1200 Herman Pressler, Houston, TX 77225 E-mail:;

© 2003 Lippincott Williams & Wilkins, Inc.