Building Trust

Trust is a critical component of the physician-patient relationship and necessary for patients to participate effectively in their medical decisions. Open communication is one of the key factors that establishes and reinforces trust.68 Thus, even relatively basic steps toward participatory decision making, such as providing adequate information to patients and listening to their opinions and concerns, may serve to increase trust in the relationship and further improve decision outcomes. Trust is greatest in relationships where the patient believes that physician values are compatible with their own.69 Such perceptions of value congruence are determined in part by the physician's behavior, practice circumstances, and payment structure, but may also be fostered by the physician demonstrating interest in and respect for the patient's life outside of their cancer diagnosis.6,70 Trust erodes when physicians fail to meet patients' expectations for communication and competency.71 Developing systems to minimize errors in either the process or outcomes of care helps to ensure that patients' expectations are met, thereby also increasing trust and facilitating participatory decision making.

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