Patients' Race, Ethnicity, Language, and Trust in a Physician

Author:

Stepanikova Irena1,Mollborn Stefanie2,Cook Karen S.3,Thom David H.4,Kramer Roderick M.5

Affiliation:

1. Irena Stepanikova is an Assistant Professor in the Department of Sociology at the University of South Carolina, Columbia. Her research interests include social psychology, racial and ethnic relations, and medical sociology. She currently studies the role of race and ethnicity in physician-patient encounters.

2. Stefanie Mollborn is an Assistant Professor in the Department of Sociology and Faculty in the Health and Society Program of the Institute of Behavioral Science at the University of Colorado at Boulder. Her research focuses on social psychological approaches to understanding health behaviors over the life course. Current projects include an analysis of the importance of material resources for teenage parents' educational outcomes and an examination of the antecedents and consequences of social norms about...

3. Karen S. Cook is the Ray Lyman Wilbur Professor of Sociology and Director of the Institute for Research in the Social Sciences at Stanford University. She has published widely on topics such as social exchange, networks, power-dependence relations, and trust. Most recently she coauthored (with R. Hardin and M. Levi) Cooperation Without Trust? (Russell Sage Foundation, 2005). She has also done work on managed care and physician-patient trust relations.

4. David Thom is Associate Professor of Family and Community Medicine at the University of California, San Francisco. Dr. Thom received his MD from the University of California, San Diego, and his MPH and PhD from the University of Washington. He has studied patient-physician trust since 1994, when he was named as one of five national Picker Scholars. He has authored more then 60 original research papers and book chapters, many of them on the topic of doctor-patient trust.

5. Roderick Kramer is the William R. Kimball Professor of Organizational Behavior in the Graduate School of Business at Stanford University. He earned his Ph.D. in social psychology from UCLA in 1985. He has been a visiting associate professor at Northwestern University's Kellogg Graduate School of Management, Oxford University, London Business School, and the John F. Kennedy School of Government at Harvard University. In the 2004–2005 academic year, he was a Visiting Senior Scholar at the Hoover Institution.

Abstract

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 non-whites 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.

Publisher

SAGE Publications

Subject

Public Health, Environmental and Occupational Health,Social Psychology

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