The Surgeon-Patient Relationship: Built Upon Trust

  • H. Alejandro Rodriguez
  • Carlos A. PellegriniEmail author


Trust, a key element of all human interactions, is especially precious in the physician-patient relationship. Without trust, a successful therapeutic relationship is often impossible. Due to the nature of their discipline, surgeons must establish a particularly strong bond of trust with their patients. The basis of this bond is clear, effective, and caring communication, the quality of which will be judged not just by what is said but how it is said. Recent shifts in society’s expectations and healthcare delivery have brought new challenges to the surgeon-patient relationship. Thus, the surgeon today must possess not only the necessary technical skills but the ability to foster trust between himself or herself, the patient, and the larger system – all while adapting to a rapid changing environment.


Trust Communication Surgeon-patient relationship Physician-patient relationship Surgeon-patient communication Physician-patient communication 


  1. 1.
    Pellegrini CA. Trust: the keystone of the patient-physician relationship. ACS. 2017;224:95–102. Scholar
  2. 2.
    Pellegrino ED, Thomasma DC. The virtues in medical practice. New York: Oxford University Press; 1993.Google Scholar
  3. 3.
    Trust. Available at: Accessed 2 Dec 2017.
  4. 4.
    Trust. Available at: Accessed 2 Dec 2017.
  5. 5.
    Barber B. The logic and limits of trust. New Brunswick: Rutgers University Press; 1983.Google Scholar
  6. 6.
    Luhmann N. Trust and power. Cambridge: Polity Press; 2017.Google Scholar
  7. 7.
    Mechanic D, Schlesinger M. The impact of managed care on patients’ trust in medical care and their physicians. JAMA. 1996;275:1693–7. Scholar
  8. 8.
    Thom DH, Wong ST, Guzman D, et al. Physician Trust in the Patient: development and validation of a new measure. Ann Fam Med. 2011;9:148–54. Scholar
  9. 9.
    Thorne SE, Robinson CA. Reciprocal trust in health care relationships. J Adv Nurs. 1988;13:782–9.CrossRefGoogle Scholar
  10. 10.
    Merrill JO, Rhodes LA, Deyo RA, et al. Mutual mistrust in the medical care of drug users. J Gen Intern Med. 2002;17:327–33.PubMedPubMedCentralGoogle Scholar
  11. 11.
    Chekhov AP. Ivanov. In: The Oxford Chekov: Ivanov; Platonov; the Seagull. Oxford: Oxford University Press; 1967.Google Scholar
  12. 12.
    McLellan MF. Literature and medicine: physician-writers. Lancet. 1997;349:564–7.CrossRefGoogle Scholar
  13. 13.
    Honesty/Ethics in Professions. Available at: Accessed 28 Jan 2018.
  14. 14.
    Davies HT, Rundall TG. Managing patient trust in managed care. Milbank Q. 2000;78:609–24; iv–v.CrossRefGoogle Scholar
  15. 15.
    Axelrod DA, Goold SD. Maintaining trust in the surgeon-patient relationship: challenges for the new millennium. Arch Surg. 2000;135:55–61.CrossRefGoogle Scholar
  16. 16.
    Kao AC, Green DC, Zaslavsky AM, et al. The relationship between method of physician payment and patient trust. JAMA. 1998;280:1708–14.CrossRefGoogle Scholar
  17. 17.
    Fox S, Duggan M. Health Online 2013. Pew internet & American Life Project. 2013. Available at: Accessed Jan 26 2018.
  18. 18.
    Loria G. How patients use online reviews. Available at:
  19. 19.
    Segal J. The role of the internet in doctor performance rating. Pain Physician. 2009;12:659–64.PubMedGoogle Scholar
  20. 20.
    Kadry B, Chu LF, Kadry B, et al. Analysis of 4999 online physician ratings indicates that most patients give physicians a favorable rating. J Med Internet Res. 2011;13:e95–13. Scholar
  21. 21.
    Lee V. Transparency and trust – online patient reviews of physicians. N Engl J Med. 2017;376:197–9. Scholar
  22. 22.
    Hill D, Feldman SR. Online reviews of physicians: valuable feedback, valuable advertising. JAMA Dermatol. 2016;152:143–4. Scholar
  23. 23.
    Okike K, Peter-Bibb TK, Xie KC, Okike ON. Association between physician online rating and quality of care. J Med Internet Res. 2016;18:e324–9. Scholar
  24. 24.
    Clapp JT, Arriaga AF, Murthy S, et al. 2017 Surgical consultation as social process: implications for shared decision making. Ann Surg.
  25. 25.
    Communication. Available at: Accessed 15 Dec 2017.
  26. 26.
    Goold SD, Lipkin M. The doctor-patient relationship. J Gen Intern Med. 1999;14:S26–33. Scholar
  27. 27.
    Levinson W, Roter DL, Mullooly JP, et al. Physician-patient communication. The relationship with malpractice claims among primary care physicians and surgeons. JAMA. 1997;277:553–9.CrossRefGoogle Scholar
  28. 28.
    Ong LM, de Haes JC, Hoos AM, Lammes FB. Doctor-patient communication: a review of the literature. Soc Sci Med. 1995;40:903–18. Scholar
  29. 29.
    Ambady N, LaPlante D, Nguyen T, et al. Surgeons’ tone of voice: a clue to malpractice history. Surgery. 2002;132:5–9. Scholar
  30. 30.
    Levinson W, Hudak PL, Feldman JJ, et al. It’s not what you say …. Med Care. 2008;46:410–6. Scholar
  31. 31.
    Gilliland WR, Rochelle JL, Hawkins R, et al. Changes in clinical skills education resulting from the introduction of the USMLE™ step 2 clinical skills (CS) examination. Med Teach. 2008;30:325–7.CrossRefGoogle Scholar
  32. 32.
    Levinson W, Lesser CS, Epstein RM. Developing physician communication skills for patient-centered care. Health Aff. 2010;29:1310–8. Scholar
  33. 33.
    Yudkowsky R, Alseidi A, Cintron J. Beyond fulfilling the core competencies: an objective structured clinical examination to assess communication and interpersonal skills in a surgical residency. Curr Surg. 2004;61:499–503. Scholar
  34. 34.
    Smith RC. The Patient’s story: integrating the patient- and physician-centered approaches to interviewing. Ann Intern Med. 1991;115:470–7. Scholar
  35. 35.
    Peabody FW. The Care of the Patient. JAMA. 1927;88:877–82. Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of SurgeryUniversity of WashingtonSeattleUSA
  2. 2.UW MedicineUniversity of WashingtonSeattleUSA

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