Physicians' trust in one another is a care safety and quality issue, experts find

If doctors don't value and trust each other, the safety and quality of patient care could potentially be compromised.

Jeff Lagasse, Associate Editor

While the importance of trusted relationships between patients and their physicians is taken for granted, little attention has been given to the relationships among physicians themselves.

Yet the interactions between, for example, a patient's primary care physician and cardiologist, or between a patient's pediatrician and an oncology team, are essential to the safety and quality of care for patients and the resilience of physicians and other healthcare professionals.

In a Viewpoint article,"Physicians' Trust in One Another," several authors write that while trust in the physician-to-physician relationship hasn't been closely examined, it appears increasingly to be at risk.

If doctors don't value and trust each other, the safety and quality of patient care could potentially be compromised, the authors found. Trust has to be infused at every level of a health system in order for it work and function successfully.


When examining where the apparent lack of trust originated, the authors looked back to the competitiveness of medical school, and as medical school ends, the competition for residencies. Do those who enter the most selective specialties look down on their primary care colleagues? Do specialists have a lack of trust in their primary care peers' judgements simply because they chose a less specialized medical career like pediatrics or family practice?

The use of electronic health records and the development of specialties such as hospital medicine have removed much of the interpersonal interaction that used to take place between primary care physicians and specialists, whether it be the phone call to discuss a case or the hallway update.

The Viewpoint article expresses concern that, in addition to having a potentially negative impact on patient care, the lack of interpersonal interaction may also be contributing to the increase in physician burnout and decreased resilience.

It highlights three initial principles to bolster physician-to-physician relationships: Recognize that physician-physician relationships are consequential and should be given the same level of attention as patient-physician and interpersonal relationships; value differences in perspective and harness them as a resource; and be accountable for creating patterns of respect and hold others accountable for creating patterns of respect and collaboration.


Burnout has been a growing problem for physicians for years now, driven in part by factors such as temperamental electronic health records and a shortage of skilled professionals relative to the number of patients. But this year, some good news: The epidemic levels of physicians reporting burnout dropped modestly in 2017. 

Twitter: @JELagasse

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