Acquaintance-Based Medical Treatment Lowered Physician-Patient Trust When the Medical Outcome Was Negative: A Vignette Experiment

Background: The Chinese medical environment has seen a long history of physician-patient distrust, which often leads to conflict and violence, creating a stressful and unsafe working environment for physicians, and further deteriorating physician-patient relationships. Therefore, it is important to understand the factors that influence physician-patient trust in order to inform interventions. The current study investigated the effect of media reports regarding medical treatment outcomes and acquaintance-based medical Treatment on physician-patient trust. Acquaintance-based medical treatment refers to people using their connections to obtain better medical resources. Methods: A vignette experiment was conducted that investigated attitudes toward physicians under positive and negative treatment outcomes among 230 cancer patients and their families (Sample 1) and a cross-validated sample consisting of 280 employees from different industries (Sample 2). Findings: The results from both samples showed that negative media reports were associated with lower perceived trust from the patients toward physicians. Additionally, the results demonstrated that when the medical outcome was positive, the participants generally did not perceive physicians they were familiar with as being more competent and trustworthy than those they were not acquainted with; however, physicians who were acquaintances were perceived as less competent when the medical outcome was negative. Interpretation: The implications include advertising positive media images of physicians to facilitate trust and reduce acquaintance-based medical treatment to make medical resources more available in China. Funding: Preparation of this work was funded by The National Social Science Fund of China (20BSH139). Declaration of Interest: The authors declare that they have no conflicts of interests. Ethical Approval: This study was approved by the IRB at Peking University.