Too much medicine: not enough trust?

Published in

  • 30 January 2019


Why it matters

Trust is an essential part of a healthy doctor-patient relationship. Doctors need to trust that patients will provide relevant and accurate information about their health, and patients need to trust doctors’ clinical judgment about the tests and treatments they need – if any.

But trust isn’t a given. Trust is built over time, and trust can be lost. When trust isn’t present between a doctor and patient, how is care affected?

This study explores whether trust between doctors and patients – or the lack of it – has influenced recent increases in medical investigations and treatments. This is an important problem, because too much medicine – including too many tests and too low a threshold for intervention – could potentially harm patients’ health.

Our approach

By reviewing evidence about the nature of the doctor-patient relationship, we provide insight on how trust might influence doctors’ decision-making about ordering investigations or prescribing treatments.

Through relevant case studies, we illustrate the decision-making dilemmas doctors face when trust is in doubt.

We also investigate ways of building trust, and the potential for healthcare systems to facilitate trust-building to ensure that decisions about tests and treatments are made ethically.

What we found

Read the full article

Related content from our open-access series, Elements of Improving Quality and Safety in Healthcare

The Positive Deviance Approach

Licensed under Creative Commons

These symbols show that the contents of this page are published under a Creative Commons licence called CC-BY-NC-ND 4.0.

It means that you’re free to reuse this work. In fact, we encourage it. We want our research to reach people who can help improve quality and safety in healthcare. But we do have a few rules:

  • Make sure you acknowledge The Healthcare Improvement Studies Institute (THIS Institute) as the creator and link back to this webpage.
  • You can’t sell this work for a fee, or use it for any activity that generates revenue without our permission.
  • Please don’t distribute a modified version to others without our permission.

You can read the fine print about the licence on the Creative Commons website. It’s meant to help us keep the integrity of our work and stay true to our values.

But ultimately we want our work to have impact. So if you’ve got a use in mind but you’re not sure it’s allowed, just ask us at