Building Trust in a Newly Established Physician-Patient Relationship: A Scoping Review

Trust is a fundamental component of the physician-patient relationship, influencing cooperation, adherence, and patient outcomes. While much research has focused on long-term relationships, little is known about the factors that shape trust during the very first physician-patient encounter.

The aim of this study was to assess the factors contributing to the development of patients' trust in a newly established physician-patient relationship.

We conducted a scoping review and applied thematic analysis to synthesise findings from identified studies. PubMed database was searched using predefined keywords for articles published between January 1975 and January 2026.

Initially, 2825 studies were identified, with 2818 remaining after duplicates were removed. Studies underwent title and abstract screening, with 142 shortlisted based on inclusion criteria. Studies were eligible if they focused on the first physician-patient encounter and trust was either the primary evaluated variable or one of the evaluated variables. Full-text assessments reduced this to 10 studies for thematic analysis.

Factors positively associated with trust building were organised according to the phase in which they appeared to influence trust: pre-consultation, during consultation, and post-consultation. In the pre-consultation phase, physician reputation, care coordination, and previous positive experiences appeared to support trust. During consultation, a warm approach, perceived technical skills, information sharing, patient participation, active listening, and empathy enhanced trust. Post-consultation, trust was reinforced by symptom relief and recovery. An apology for medical errors was crucial as well. Conversely, limited opportunities to ask questions, time constraints, unmet expectations, stigmatisation, and inappropriate language appeared to be negatively associated with trust.

The findings suggest that trust building begins before the initial encounter, continues throughout the consultation itself, and may be reinforced by experiences following the visit. Trust between physicians and new patients appears to be shaped by both technical competence and communication skills. Medical education should therefore encompass both domains to support high-quality care and effective clinical relationships.