Situated Trust in a Physician: Patient Health Characteristics and Trust in Physician Confidentiality

ABSTRACT

Most patients trust their physicians uniformly across several situations, which challenges prevailing perspectives on interpersonal trust that view it as situated (placed upon a specific person for a specific task within a situation). We suggest this finding is an artifact of undertheorizing about how situations shape patients’ trust. We develop claims explaining how patients’ devalued health characteristics raise situation-specific concerns. We find that the severity and chronic severity of body weight and depressive symptoms are associated with lower trust in physician confidentiality-–-the expectation that a physician uses personal health information appropriately-–but not trust for other tasks.

KEYWORDS:

• Interpersonal trust
• privacy
• patient-physician interaction
• health disparities

Acknowledgments

The authors would like to thank the Wisconsin Longitudinal Study (WLS) Pilot Grant Program for funding the preparation of the manuscript. Jason Houle, Valerie Lewis, Kathryn Lively, Emily Walton, and two anonymous reviewers offered helpful comments on earlier drafts. We also thank Connor Lynch for his research assistance. The research uses data from the WLS of the University of Wisconsin-Madison. Since 1991, the WLS has been supported principally by the National Institute on Aging (AG-9775 and AG-21079), with additional support from the Vilas Estate Trust, the National Science Foundation, the Spencer Foundation, and the Graduate School of the University of Wisconsin–Madison. A public use file of data from the WLS is available from the Wisconsin Longitudinal Study, University of Wisconsin-Madison, 1180 Observatory Drive, Madison, Wisconsin 53706, and at http://www.ssc.wisc.edu/~wls/data/. The interpretations, opinions, and inferences based on the data are solely the responsibility of the authors.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by the Wisconsin Longitudinal Study Pilot Grant (https://www.ssc.wisc.edu/wlsresearch/pilot/).

Notes on contributors

Celeste Campos-Castillo

Celeste Campos-Castillo, Ph.D., is an Assistant Professor of Sociology at the University of Wisconsin-Milwaukee. She studies disparities in patient-physician interaction and how health information technologies may narrow or exacerbate them. Her current research examines how technologies disrupt the ability of individuals to manage the privacy of others, with a particular focus on clinicians managing patient privacy and adolescents managing the privacy of their peers.

Denise Anthony

Denise Anthony, Ph.D., is Professor of Health Management & Policy in the School of Public Health, and in the Department of Sociology (by courtesy), at the University of Michigan. Her work explores issues of cooperation, trust and privacy in a variety of settings, from health care delivery to micro-credit borrowing groups to online groups such as Wikipedia and  Prosper.com. Her current work examines the use of information technology in health care, including effects on quality, on the organization of health care, as well as the implications for the privacy and security of protected health information.