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Trust me - I'm a doctor

Research highlights the unique values of GP-patient relationships

Presentation of Findings on 6 February, At 5.30pm, University of Leicester

Reforms to the delivery of primary care should ensure that patients are able to maintain an ongoing relationship with a GP, a new study from the University of Leicester suggests. Continuing relationships provide a setting in which trust, cooperation, and quality of care can flourish.

These are the findings of doctoral research by Carolyn Tarrant for the School of Psychology at the University of Leicester. Dr Tarrant is now a Wellcome Trust post-doctoral researcher in the Department of Health Sciences at the University of Leicester.

Her research involved exploring the factors that promote trust and cooperation between patients and their GPs.

She will be presenting her findings at the University of Leicester's Doctoral Inaugural Lectures on 6 February. The Doctoral Inaugural Lectures will celebrate and showcase PhD students who are both outstanding academically and able to present their work in a way that is accessible and engaging to a wider University audience.

Dr Tarrant commented: "Recent reforms of primary care in the UK have led to a shift away from the traditional model of primary care that had the personal family doctor at its heart. Modern primary care emphasises quick access and choice. Care is increasingly often provided by teams of health professionals, and by other providers such as NHS Direct and NHS walk-in centres. It is less often provided by GPs who know their patients personally. Although this is likely to have certain benefits for patients and certainly for GPs, a fundamental feature of primary care - the GP-patient relationship - is under threat.

"My research suggested that ongoing relationships help to build secure and robust patient trust, and can promote cooperation between patient and GP. Although patients generally trust unfamiliar GPs, they report higher trust when they have had positive experiences with a particular GP in the past, and when they expect to see the same GP again in the future. Seeing the same GP repeatedly reduces uncertainty and can build a secure form of trust based on personal knowledge and emotional ties. Secure trust means that patients are happier to disclose sensitive information, feel more confident that they will get the right treatment, and are more willing to accept GPs' advice or treatment. GPs feel that ongoing relationships help to achieve cooperative outcomes and make it easier for them to deal with difficult patients and sensitive issues. Ongoing relationships can motivate GPs to provide good quality care.

"My research findings indicate that primary care provided through ongoing GP-patient relationships is conceptually distinct from other modes of service provision. It has unique features that can promote trust, cooperation and quality of care. These features cannot be replicated in a one-off consultation."

Dr Tarrant used game theory to provide a theoretical framework for her research. Game theory is well established in psychology, but its application to doctor-patient relationships has hitherto been limited.

Her findings come from a survey of 279 primary care patients, and in-depth interviews with 20 patients and 12 GPs, all from the Leicestershire area.

The second doctoral inaugural lecture will take place on Wednesday 6th February at 5.30pm in Ken Edwards Lecture Theatre 3. In addition to Carolyn Tarrant it will also feature Joanne Cowe (Medical Physics, Cardiovascular Sciences) talking about her research on "From military radar to medical ultrasound: translating the techniques". Please email pgevents@le.ac.uk for further information or if you would like to attend.

Source: U.S. Department of State