Dynamics of Trust in Doctor-Patient Relationship in India: A Clinical, Social and Ethical Analysis

Springer Singapore (2019)
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Abstract

This book offers an easy-to-read, yet comprehensive introduction to practical issues in doctor–patient relationships in a typical low- and middle-income country setting in India, examining in detail the reasons for erosion of trust and providing guidance on potential research areas in the field. It strikes a balance between empirical work and theoretical normative analysis, while adopting mixed-method research in exploring important constructs in the doctor–patient relationship, such as trust, solidarity, advocacy, patient-centeredness, privacy, and confidentiality. Since the concept of trust has direct implications for the ethical practice of medicine, the book is a valuable resource for academics and researchers in the field of medical, clinical, and applied ethics.

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Chapters

Building Trust Through Building Trustworthiness

Can trust be built? In the context of growing mistrust on physicians and healthcare systems among communities, what is the solution? These questions are difficult to answer. A sound analysis of the concept of trust leads to the understanding that trust building comes out of building trustworthy phys... see more

Trust in Physicians as a Quality Improvement Measure

Patient experiences and patient-reported outcomes are increasingly used to measure quality of health care. Patient satisfaction surveys have been used as a health quality metric for several years. It is possible to conceptualize trust in physicians as a quality indicator, complementary to patient sa... see more

Trust, Trustworthiness and the Physician–Patient Relationship in Developing Healthcare Settings

Trustworthiness is an important virtue in physicians. It is the underlying virtue which makes patients trust their physician. The social construct of trust in physicians is valuable only if it is based on the trustworthiness of the physician. There are situations where trust is placed on the untrust... see more

Perceptions of Healthcare Providers on Trust in Physicians

Trust in physicians is perceived differently by the community compared to healthcare providers themselves. While the community laid more emphasis on communication, behaviour, comfort, personal involvement and competence, the healthcare providers emphasized on competence and minimizing errors are the... see more

How to Measure Trust in Physicians?

In this chapter, the process of development and validation of a scale to quantify trust in physicians in the local healthcare setting is described. The scale development process has been informed by both the classical test and item response approaches. At the end of the process of scale development ... see more

What Influences Patients’ Trust in Physicians?

This chapter describes the various factors that influence trust in physicians in the context of the study. Comfort and shared identity, personal involvement of the physician with the patient, communication, behaviours and approach of the physician, economic factors and health awareness of the patien... see more

Meaning of Trust in Physicians in Developing Healthcare Settings

In the setting where this study was conducted, the key dimensions of trust in physicians were perceived competence of the physician, assurance of treatment, willingness to accept drawbacks in the physician–patient relationship, loyalty towards the physician and respect. Based on these identified dim... see more

Community-Based Exploratory Research on Trust in Physicians

In this chapter, I describe the various research methods I adopted to explore the idea of trust in physicians in the study setting. The study was conducted in Tamil Nadu, a state in southern part of India with good health indicators. The initial exploration was carried out using a mixed qualitative ... see more

Introduction

Trust is the optimistic acceptance of one’s vulnerability in the best belief that the trusted party will do whatever is in the best interest of the one who is trusting. There is substantial scholarship of trust in health care, with specific focus on trust in the physician–patient relationship. From ... see more

Conclusion

This concluding chapter summarizes the strengths and limitations of this study on trust in physicians. There are three possible lines of enquiry that this research leads to—exploring trust in physicians as a quality indicator in health care, developing trust as a key ethical value in medicine and ex... see more

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