Trust in the health care system: The risks of placing confidence in professional communities
Sociology Russian Academy of Science & University of Hertfordshire Moscow, Russia
Forming and sustaining trustful relationships between patients and doctors seems to be of paramount importance for the correct functioning of medical care systems, since they by necessity embrace emotionally-driven interactions among the people involved in this area of activity. In turn, personal attitudes, which are developing within the patient - doctor dyads, are molded by the vehicles of institutional support built into the medical care systems.
But what precisely are the reasons for experiencing trust in the systems of medical care, that is, an array of organizations and institutions aiming at preventing ailments, curing them and subsequently rehabilitating their patients? Certainly, our specific knowledge cannot serve as a foundation for this form of trusting attitudes. Were we ourselves knowledgeable in medicine, we would feel much less need for developing patterns of trust in physicians. Expertise at our disposal would perform the controlling function in the area of medical assignments, while simultaneously protecting us from potentially harmful actions of medical systems and diminishing the need for forging trustful relationships with their constituents. On the contrary, when we are dependent on a medical care system as a result of lack of professional knowledge coupled with helplessness of being ill, signs of doctors' competence and integrity bear direct connection to developing trusting attitudes towards them and creating a sense of security despite possible health hazards.
We must take into account, however, that this sense of trust and safety is to a large extent founded on illusionary expectations. We are trying to assure ourselves that, in the situation of our ignorance or partial knowledge, our manifestations of trust are safeguarded, guaranteed or insured by the higher-order institutions, which are lowering our vulnerability to the systems of medical care. Essentially, we are involved into building characteristic pyramids of trust, so that the responsibility for the proper functioning of underlying systems is being transferred to ever higher levels of hierarchical structures. The arising problem of infinite regress spoils the attempts at building the reliable foundations of placing confidence in the professional medical systems.