Skip to main content
Top
Published in: BMC Health Services Research 1/2019

Open Access 01-12-2019 | Research article

Factors associated with the public’s trust in physicians in the context of the Lebanese healthcare system: a qualitative study

Authors: Bashir Shaya, Nadine Al Homsi, Kevin Eid, Zeinab Haidar, Ali Khalil, Kelly Merheb, Gladys Honein-Abou Haidar, Elie A. Akl

Published in: BMC Health Services Research | Issue 1/2019

Login to get access

Abstract

Background

The Lebanese public perceives the physician-patient relationship as flawed. The objectives of this study are to assess factors associated with the public’s trust in physicians in the context of the Lebanese healthcare system and to explore potential ways to enhance it.

Methods

We conducted a qualitative study based on a grounded theory methodology using semi-structured interviews with members of the Lebanese public (not restricted to patients). We selected participants through convenience and maximum variation sampling approaches. The constant comparative analysis resulted in a theoretical framework that describes the factors influencing trust in physicians.

Results

Participants trusted an experienced, up-to-date, graduate of a North American or Western European school, working in a reputable hospital, with a high level of diagnostic skills. The personal characteristics that improved trust were physicians who are ‘non-materialistic’, have a good rapport, and have sufficient encounter time with patients. Social factors that enhance trust in the physician include: being a family member, recommended by a family member, featured in mainstream media, and/or having a good reputation. Trust increased compliance, loyalty despite occasional mistakes committed, high consultation fees, and negative attitudes towards the physician’s institution. Conversely, no trust led to severed therapeutic relationship and seeking second opinions.

Conclusion

The level of trust of members of the Lebanese public in physicians was affected by the personal characteristics of physicians, their practice or clinical skills, their interactions with the patient, finances, in addition to a number of social factors. Moreover, the level of trust had major implications on patients’ interactions with their physicians.
Appendix
Available only for authorised users
Literature
1.
go back to reference Möllering G. The nature of trust: from Georg Simmel to a theory of expectation, interpretation and suspension. Sociology. 2001;35(2):403–20.CrossRef Möllering G. The nature of trust: from Georg Simmel to a theory of expectation, interpretation and suspension. Sociology. 2001;35(2):403–20.CrossRef
2.
go back to reference Simmel G. The philosophy of money: Routledge; 2004. Simmel G. The philosophy of money: Routledge; 2004.
3.
go back to reference Meyer S, Ward P, Coveney J, Rogers W. Trust in the health system: an analysis and extension of the social theories of Giddens and Luhmann. Health Sociol Rev. 2008;17(2):177–86.CrossRef Meyer S, Ward P, Coveney J, Rogers W. Trust in the health system: an analysis and extension of the social theories of Giddens and Luhmann. Health Sociol Rev. 2008;17(2):177–86.CrossRef
4.
go back to reference Pearson SD, Raeke LH. Patients’ trust in physicians: many theories, few measures, and little data. J Gen Intern Med. 2000;15(7):509–13.CrossRef Pearson SD, Raeke LH. Patients’ trust in physicians: many theories, few measures, and little data. J Gen Intern Med. 2000;15(7):509–13.CrossRef
5.
go back to reference Croker JE, Swancutt DR, Roberts MJ, Abel GA, Roland M, Campbell JL. Factors affecting patients’ trust and confidence in GPs: evidence from the English national GP patient survey. BMJ Open. 2013;3(5):e002762.CrossRef Croker JE, Swancutt DR, Roberts MJ, Abel GA, Roland M, Campbell JL. Factors affecting patients’ trust and confidence in GPs: evidence from the English national GP patient survey. BMJ Open. 2013;3(5):e002762.CrossRef
6.
go back to reference Skirbekk H, Middelthon AL, Hjortdahl P, Finset A. Mandates of trust in the doctor-patient relationship. Qual Health Res. 2011;21(9):1182–90.CrossRef Skirbekk H, Middelthon AL, Hjortdahl P, Finset A. Mandates of trust in the doctor-patient relationship. Qual Health Res. 2011;21(9):1182–90.CrossRef
7.
go back to reference Hall MA, Dugan E, Zheng B, Mishra AK. Trust in physicians and medical institutions: what is it, can it be measured, and does it matter? The milbank quarterly. 2001;79(4):613–39.CrossRef Hall MA, Dugan E, Zheng B, Mishra AK. Trust in physicians and medical institutions: what is it, can it be measured, and does it matter? The milbank quarterly. 2001;79(4):613–39.CrossRef
8.
go back to reference Hillen MA, de Haes HC, Smets EM. Cancer patients' trust in their physician—a review. Psycho-Oncology. 2011;20(3):227–41.CrossRef Hillen MA, de Haes HC, Smets EM. Cancer patients' trust in their physician—a review. Psycho-Oncology. 2011;20(3):227–41.CrossRef
9.
go back to reference Rowe R, Calnan M. Trust relations in health care--the new agenda. Eur J Pub Health. 2006;16(1):4–6.CrossRef Rowe R, Calnan M. Trust relations in health care--the new agenda. Eur J Pub Health. 2006;16(1):4–6.CrossRef
10.
go back to reference Huang EC-H, Pu C, Chou Y-J, Huang N. Public Trust in Physicians—Health Care Commodification as a possible deteriorating factor: cross-sectional analysis of 23 countries. INQUIRY: J Health Care Organ, Prov, Financ. 2018;55:0046958018759174. Huang EC-H, Pu C, Chou Y-J, Huang N. Public Trust in Physicians—Health Care Commodification as a possible deteriorating factor: cross-sectional analysis of 23 countries. INQUIRY: J Health Care Organ, Prov, Financ. 2018;55:0046958018759174.
11.
go back to reference Armstrong K, Rose A, Peters N, Long JA, McMurphy S, Shea JA. Distrust of the health care system and self-reported health in the United States. J Gen Intern Med. 2006;21(4):292–7.CrossRef Armstrong K, Rose A, Peters N, Long JA, McMurphy S, Shea JA. Distrust of the health care system and self-reported health in the United States. J Gen Intern Med. 2006;21(4):292–7.CrossRef
12.
go back to reference Zheng H. Losing confidence in medicine in an era of medical expansion? Soc Sci Res. 2015;52:701–15.CrossRef Zheng H. Losing confidence in medicine in an era of medical expansion? Soc Sci Res. 2015;52:701–15.CrossRef
13.
go back to reference Zhao D, Zhang Z. Changes in public trust in physicians: empirical evidence from China. Frontiers Med. 2018:1–7. Zhao D, Zhang Z. Changes in public trust in physicians: empirical evidence from China. Frontiers Med. 2018:1–7.
14.
go back to reference Arawi T. The Lebanese physician: a public's viewpoint. Developing World Bioethics. 2010;10(1):22–9.CrossRef Arawi T. The Lebanese physician: a public's viewpoint. Developing World Bioethics. 2010;10(1):22–9.CrossRef
15.
go back to reference Corbin J, Strauss A. Basics of qualitative research: techniques and procedures for developing grounded theory. 3rd ed. Thousand Oaks, CA, US: Sage Publications, Inc; 2008. xv. p. 379–xv. Corbin J, Strauss A. Basics of qualitative research: techniques and procedures for developing grounded theory. 3rd ed. Thousand Oaks, CA, US: Sage Publications, Inc; 2008. xv. p. 379–xv.
16.
go back to reference Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19(6):349–57.CrossRef Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19(6):349–57.CrossRef
17.
go back to reference Lincoln YS, Guba YSLEG, Guba EG. Naturalistic Inquiry: SAGE Publications; 1985. Lincoln YS, Guba YSLEG, Guba EG. Naturalistic Inquiry: SAGE Publications; 1985.
18.
go back to reference Mechanic D, Meyer S. Concepts of trust among patients with serious illness. Soc Sci Med. 2000;51(5):657–68.CrossRef Mechanic D, Meyer S. Concepts of trust among patients with serious illness. Soc Sci Med. 2000;51(5):657–68.CrossRef
19.
go back to reference Hwong AR, Sah S, Lehmann LS. The effects of public disclosure of industry payments to physicians on patient trust: a randomized experiment. J Gen Intern Med. 2017;32(11):1186–92.CrossRef Hwong AR, Sah S, Lehmann LS. The effects of public disclosure of industry payments to physicians on patient trust: a randomized experiment. J Gen Intern Med. 2017;32(11):1186–92.CrossRef
20.
go back to reference CSc C. Mistrust of physicians in China: society, institution, and interaction as root causes. Developing World Bioethics. 2018;18(1):16–25.CrossRef CSc C. Mistrust of physicians in China: society, institution, and interaction as root causes. Developing World Bioethics. 2018;18(1):16–25.CrossRef
21.
go back to reference Goold SD, Klipp G. Managed care members talk about trust. Soc Sci Med. 2002;54(6):879–88.CrossRef Goold SD, Klipp G. Managed care members talk about trust. Soc Sci Med. 2002;54(6):879–88.CrossRef
22.
go back to reference Thom DH, Campbell B. Patient-physician trust: an exploratory study. J Fam Pract. 1997;44(2):169–77.PubMed Thom DH, Campbell B. Patient-physician trust: an exploratory study. J Fam Pract. 1997;44(2):169–77.PubMed
23.
go back to reference Thom DH, Hall MA, Pawlson LG. Measuring patients’ trust in physicians when assessing quality of care. Health Aff. 2004;23(4):124–32.CrossRef Thom DH, Hall MA, Pawlson LG. Measuring patients’ trust in physicians when assessing quality of care. Health Aff. 2004;23(4):124–32.CrossRef
24.
go back to reference Choy HH, Ismail A. Indicators for medical mistrust in healthcare–a review and standpoint from Southeast Asia. Malaysian J Med Sc: MJMS. 2017;24(6):5.CrossRef Choy HH, Ismail A. Indicators for medical mistrust in healthcare–a review and standpoint from Southeast Asia. Malaysian J Med Sc: MJMS. 2017;24(6):5.CrossRef
25.
go back to reference Gopichandran V, Chetlapalli SK. Dimensions and determinants of trust in health care in resource poor settings–a qualitative exploration. PLoS One. 2013;8(7):e69170.CrossRef Gopichandran V, Chetlapalli SK. Dimensions and determinants of trust in health care in resource poor settings–a qualitative exploration. PLoS One. 2013;8(7):e69170.CrossRef
26.
go back to reference Zhao D-H, Rao K-Q, Zhang Z-R. Patient trust in physicians: empirical evidence from Shanghai, China. Chin Med J. 2016;129(7):814.CrossRef Zhao D-H, Rao K-Q, Zhang Z-R. Patient trust in physicians: empirical evidence from Shanghai, China. Chin Med J. 2016;129(7):814.CrossRef
27.
go back to reference Liu FR. HMOs and patient Trust in Physicians a Longitudinal Study. Int J Appl Econ. 2013;10(1):1–21. Liu FR. HMOs and patient Trust in Physicians a Longitudinal Study. Int J Appl Econ. 2013;10(1):1–21.
Metadata
Title
Factors associated with the public’s trust in physicians in the context of the Lebanese healthcare system: a qualitative study
Authors
Bashir Shaya
Nadine Al Homsi
Kevin Eid
Zeinab Haidar
Ali Khalil
Kelly Merheb
Gladys Honein-Abou Haidar
Elie A. Akl
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2019
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-019-4354-0

Other articles of this Issue 1/2019

BMC Health Services Research 1/2019 Go to the issue