Health researchers find well-educated have less faith in cardiologists

The more education you have, the less likely you are to trust your heart doctor, according to a study by York University researchers.

In the first study to focus solely on patient trust in cardiologists, researchers from the University’s Faculty of Health surveyed more than 1,000 heart patients from across southern Ontario. They found that patients with postsecondary educations reported less trust in their cardiologist.

Patients who reported greater trust in their cardiologist tended to be less educated, had higher blood pressure and also perceived greater control over their heart condition.

“The relationship between hypertension and greater trust suggests that such perceptions may not be based on doctor competence,” says Sheena Kayaniyil (MSc ’08), who conducted the research as a master’s student in York’s School of Kinesiology & Health Science, under the supervision of Professor Sherry Grace (left). Kayaniyil is currently a PhD student in the University of Toronto’s Faculty of Medicine.

“In addition, patients of higher socio-economic status generally have greater access to care and more opportunity to select their doctor, yet we did not see higher levels of trust in those patients,” Kayaniyil says.

Patients of 97 cardiologists completed a mailed survey, including the Trust in Physician Scale, in addition to assessments of socio-demographic, clinical and psychosocial factors.

Researchers also found that patients’ trust in their cardiologist is equivalently high to trust in family doctors, where similar results have been reported.

Grace, the study’s senior author, expected to uncover significant differences in trust along lines of gender.

“It’s surprising that women are as trusting of their cardiologists as men,” Grace says. “Reports suggest that even doctors perceive cardiovascular disease as a man’s disease, and there are delayed diagnoses and lower rates of interventional treatments when compared to men.”

Contrary to previous findings of lower trust among African American or Asian patients, the study shows no significant difference in doctor trust by ethnic background.

Grace notes that trust in one’s doctor has been associated with increased treatment adherence, patient satisfaction, and improved health status – hence its importance as an avenue for further inquiry.

“Trust in one’s health-care provider is tremendously important,” says Grace. “We know that it can foster compassion and better quality of care, and can result in a higher level of treatment adherence. This is particularly crucial for cardiac patients, who often have multiple recommendations from their specialist on how to manage their condition and prevent further complications.”

The study, “Degree and correlates of patient trust in their cardiologist”, was published in August in the Journal of Evaluation in Clinical Practice. The study was funded by the Canadian Institutes of Health Research.