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Continuity and trust in primary care: a qualitative study informed by game theory
Carolyn Tarrant1, Mary Dixon-Woods, Andrew M Colman
1Department of Health Sciences, University of Leicester, Leicester, UK.
Annals of Family Medicine
|September 17, 2010
Summary
Patient trust in general practitioners (GPs) grows with repeated interactions. Continuity of care fosters secure trust, which may be undermined by service designs prioritizing single encounters over ongoing relationships.
Area of Science:
- Primary Care Research
- Health Services Research
- Sociology of Medicine
Background:
- The link between continuity of care and patient trust in primary care settings requires further elucidation.
- Existing research has not fully explored the nuances of how patients develop trust in their general practitioners (GPs).
Purpose of the Study:
- To empirically investigate patients' accounts of trust in general practitioners (GPs).
- To explore the relationship between continuity of care and patient trust in primary care, informed by game theory.
Main Methods:
- Conducted a qualitative study using the constant comparative method.
- Analyzed 20 semistructured interviews with patients in the United Kingdom regarding their trust in GPs.
Main Results:
- Patients initially rely on institutional trust in medicine and doctors as professionals.
- Repeated interactions with a GP allow for the development of secure trust, based on past experiences and anticipated future encounters.
- Patients perceive their GP as unique, not interchangeable, especially when convinced the doctor prioritizes their interests.
Conclusions:
- Secure patient trust in GPs develops through the dynamics of repeated interactions and continuity of care.
- Current healthcare service designs in the UK, focusing on access over continuity, may impede the development of secure patient trust.
- Findings suggest that patients value the relationship with a specific GP, challenging the notion of interchangeable primary care providers.
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