Patients' race, ethnicity, language, and trust in a physician

We examine whether racial/ethnic/language-based variation in measured levels of patients' trust in a physician depends on the survey items used to measure that trust. Survey items include: (1) a direct measure of patients' trust that the doctor will put the patient's medical needs above all other considerations, and (2) three indirect measures of trust asking about expectations for specific physician behaviors, including referring to a specialist, being influenced by insurance rules, and performing unnecessary tests. Using a national survey, we find lower scores on indirect measures of trust in a physician among minority users of health care services than among non-Hispanic white users. In contrast, the direct measure of trust does not differ among non-Hispanic whites and nonwhites once we control for potential confounding factors. The results indicate that racial/ethnic/language-based differences exist primarily in those aspects of patients' trust in a physician that reflect specific physician behaviors.