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Patients’ Commitment to Their Primary Physician and Why It Matters

¹ Mays Business School, Texas A&M University, College Station
² McCoy College of Business Administration, Texas State University, San Marcos
³ Scott and White, Texas A&M University Health Science Center, Temple
⁴ Scott and White Clinic, Texas A&M University Health Science Center, College Station
⁵ University of Cincinnati Medical Center, Cincinnati, Ohio

CORRESPONDING AUTHOR: Leonard L. Berry, PhD, M.B. Zale Chair in Retailing and Marketing Leadership, Department of Marketing, Mays Business School, Texas A&M University College Station, TX 77843-4112, BerryLe{at}tamu.edu

PURPOSE The patient-physician relationship is the cornerstone of health care service delivery. The objectives of this study were to assess the contribution of relationship commitment along with trust to patient-physician relationships and to evaluate the association of commitment and trust with adherence to medical advice and healthy eating behaviors.

METHODS To test the proposed model, we developed a questionnaire that included both existing scales and a scale constructed specifically for the study; the questions addressed trust, commitment, adherence to physicians’ medical recommendations, and healthy eating behavior. The questionnaire was given to adult patients in the waiting rooms of 4 large clinics in central Texas.

RESULTS A total of 1,008 patients returned questionnaires; 869 patients’ questionnaires were complete and used in the analysis. A 3-stage least squares analysis that tested a system of 4 equations which included relationship commitment yielded a systemwide R² of 0.71 that was 0.09 higher than a system of equations excluding relationship commitment. Trust and commitment were positively associated with adherence (P <.001 and P = .02, respectively). We also found positive relationships between adherence and commitment and between trust and commitment (P <.001 for each). Adherence and commitment were both associated with healthy eating behavior as well (P <.001 for each).

CONCLUSIONS Patients’ trust in their physician and commitment to the relationship offer a more complete understanding of the patient-physician relationship. In addition, trust and commitment favorably influence patients’ health behaviors.

Key Words: Physician-patient relations • relationship commitment • trust • physician behavior • patient adherence • patient compliance • healthy eating behavior • primary care

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