Situational trust and co-operative partnerships between physicians and their patients: a theoretical explanation transferable from business practice

A model to explain interpersonal trust development, and its consequences fo r co-operative behaviour in doctor/patient partnerships derived from the co ntext of business relationships is applied to patient/physician relationshi ps. Threshold barriers exist against all human behaviours or actions and tr ust is the process by which barriers to co-operation and compliance are ove rcome. Dispositional trust (a psychological trait to be trusting) is domina nt in the early stages of a relationship and contributes to the weight of s ubsequent trust development. Go-operative behaviour or compliance ultimatel y requires a secure situational trust emerging from consultations, which is carried forward as learnt trust and modified in each subsequent consultati on. The model comprises three types of situational trust (calculus-based, k nowledge-based, and identification trust) and five co-operation criteria fr om which to determine an individual's tendency for cooperative behaviour. T hese model components can be identified and mapped from a range of qualitat ive data, with the aim of enhancing co-operative behaviour and efficiently achieving optimal patient compliance.