Trust: the scarcest of medical resources

Truth and trust go hand in hand. ¹ When truth is compromised, trust may be sacrificed. Given the potential for bluffing, puffing, and spinning in health care, it is not surprising that trust between doctor and patient has been adversely affected. The potential for patients to trust their health plans, doctors and the institution of medicine itself may be impaired by managed care. ² Moreover, scholars are aware of the importance of trust for the doctor-patient relationship and, in turn, the need for health plans to monitor its loss. ³ Concern about compromised trust between doctor and patient has led sóme scholars to search for alternatives to the trust of the traditional doctor-patient relationship. ⁴ At the time of writing, some empirical studies show that trust in physicians has diminished only slightly, ⁵ and that the public is concerned about managed-care plans. ⁶ However, it would be a mistake to assume from this that trust between patient and physician is infinitely robust. Given what we know about trust between doctor and patient, it is predictable that if the doctor-patient relationship continues to be stressed, trust will continue its downward slide.