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A Two-Way Street: Building Trust Between People with Medicaid and Primary Care Doctors

October 15, 2020

Trust is central to relationships between patients and health care providers. Patients who are more trusting of their providers tend to be more satisfied with their treatment, behave in ways that are more beneficial to their health and report fewer symptoms and have a higher quality of life. Physicians need to trust their patients to provide reliable information, participate in complex and potentially high-stakes decisions and follow treatment plans.

Public Agenda has released findings from a new study examining how to build mutual trust between people insured by Medicaid and primary care physicians. This report is unique in that it looks not only at patients’ trust in doctors, but also doctors’ trust in patients and it explores factors that build and damage mutual trust and makes practical recommendations for doctors and others in the field. Read the full report here.

 Key findings:

  • Primary care doctors and people with Medicaid agree that trust should be mutual. Both feel equally responsible for building it and both feel that it takes time to develop.
  • Doctors overwhelmingly trust patients with Medicaid unless that trust is broken. But more people with Medicaid express wariness, with nearly 4 in 10 saying doctors need to earn their trust. 
  • Following basic safety protocols is cited by patients with Medicaid as one of the top factors affecting trust, whereas doctors think it is more important to consider their patients’ finances and lifestyles in order to build trust.
  • Nearly 4 in 10 people with Medicaid say they have been treated by a primary care doctor whom they did not trust. Most people who have had those negative experiences say that as a result, they have behaved in ways that could negatively affect their health, such as stopping medications or delaying care.
  • Primary care doctors largely feel that patients with Medicaid are just as trustworthy as patients with other types of insurance. When patients with Medicaid are actively engaged in their care, such as by participating in decisions or voicing their health goals, primary care doctors trust them more. 

The research involved representative surveys of each population and separate focus groups with each population. This research was supported by a grant from the Robert Wood Johnson Foundation. The views expressed here do not necessarily reflect the views of the Foundation.

Read the report.