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Alan L. Hillman, MD, MBA

JAMA. 1998;280:1703-1704.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Trust—a firm belief or confidence in the honesty, integrity, reliability, and justice of another person or thing¹—is the critical foundation of an effective patient-physician relationship. Not long ago, trust was paramount; it certainly never was a problem for Marcus Welby. However, some of the tools that managed care has introduced to influence physician behavior toward efficient and high-quality medical care (although some critics doubt its commitment to the latter) have made evaluation of patient trust a legitimate scientific question. These managed care tools include rules (eg, mandatory clinical protocols, retrospective and prospective utilization review) and financial incentives (eg, various methods of payment).²

In this issue of THE JOURNAL, Kao and colleagues³ report the results of a study in which they asked a large cross-section of patients a variety of questions about trust, including "How much do you trust your doctor to put your health . . . [Full Text of this Article]

From the Center for Health Policy, Leonard Davis Institute of Health Economics, School of Medicine, University of Pennsylvania, Philadelphia.

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