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Editorial
November 18, 1998

Mediators of Patient Trust

Author Affiliations

From the Center for Health Policy, Leonard Davis Institute of Health Economics, School of Medicine, University of Pennsylvania, Philadelphia.

JAMA. 1998;280(19):1703-1704. doi:10.1001/jama.280.19.1703

Trust—a firm belief or confidence in the honesty, integrity, reliability, and justice of another person or thing1—is the critical foundation of an effective patient-physician relationship. Not long ago, trust was paramount; it certainly never was a problem for Marcus Welby. However, some of the tools that managed care has introduced to influence physician behavior toward efficient and high-quality medical care (although some critics doubt its commitment to the latter) have made evaluation of patient trust a legitimate scientific question. These managed care tools include rules (eg, mandatory clinical protocols, retrospective and prospective utilization review) and financial incentives (eg, various methods of payment).2

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