title: Patients' commitment to their primary physician and why it matters.
abstract: OBJECTIVE
  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 R(2) 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.
authors.affiliation: Department of Marketing, Mays Business School, Texas A&M University, College Station, TX 77843-4112, USA. BerryLe@tamu.edu
authors.forename: Leonard L
authors.initials: LL
authors.lastname: Berry
authors.forename: Janet Turner
authors.initials: JT
authors.lastname: Parish
authors.forename: Ramkumar
authors.initials: R
authors.lastname: Janakiraman
authors.forename: Lee
authors.initials: L
authors.lastname: Ogburn-Russell
authors.forename: Glen R
authors.initials: GR
authors.lastname: Couchman
authors.forename: William L
authors.initials: WL
authors.lastname: Rayburn
authors.forename: Jedidiah
authors.initials: J
authors.lastname: Grisel
mesh_terms: D001294:Attitude to Health; D003266:Continuity of Patient Care / Q000592:standards*; D004032:Diet; D005247:Feeding Behavior / Q000523:psychology; D005260:Female; D006123:Group Practice; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D010817:Physician-Patient Relations; D010821:Physicians, Family; D011795:Surveys and Questionnaires; D035502:Trust / Q000523:psychology