title: Do emergency physicians trust their patients?
abstract: The primary focus of research on the physician-patient relationship has been on patients' trust in their physicians. In this study, we explored physicians' trust in their patients. We held semi-structured interviews with expert emergency physicians concerning a patient they had just been managing. The physicians had been equipped with a head-mounted micro camera to film the encounter from an "own point of view perspective". The footage was used to stimulate recall during the interviews. Several participants made judgments on the reliability of their patients' accounts from the very beginning of the encounter. If accounts were not deemed reliable, participants implemented a variety of specific strategies in pursuing their history taking, i.e. checking for consistency by asking the same question at several points in the interview, cross-referencing information, questioning third-parties, examining the patient record, and systematically collecting data held to be objective. Our study raises the question of the influence of labeling patients as "reliable" or "unreliable" on their subsequent treatment in the emergency department. Further work is necessary to examine the accuracy of these judgments, the underlying cognitive processes (i.e. analytic versus intuitive) and their influence on decision-making.
authors.affiliation: Centre for Training and Research in Health Sciences Education (CFR-PS), Faculty of Medicine, University of Strasbourg, 67085, Strasbourg, France. pelaccia@unistra.fr.|Prehospital Emergency Care Service (SAMU 67), Strasbourg University Hospital, PO Box 426, 67200, Strasbourg, France. pelaccia@unistra.fr.
authors.forename: Thierry
authors.initials: T
authors.lastname: Pelaccia
authors.affiliation: Department of Pedagogy, Faculty of Education, University of Sherbrooke, Sherbrooke, QC, J1K 2R1, Canada.
authors.forename: Jacques
authors.initials: J
authors.lastname: Tardif
authors.affiliation: Faculty of Educational Sciences, University of Strasbourg, 67000, Strasbourg, France.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Triby
authors.affiliation: Department of Emergency Medicine, Amiens University Hospital, 80054, Amiens, France.
authors.forename: Christine
authors.initials: C
authors.lastname: Ammirati
authors.affiliation: Prehospital Emergency Care Service (SAMU 94), Henri-Mondor Hospital, Public Hospitals of Paris, 94000, Créteil, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Bertrand
authors.affiliation: Centre of Pedagogy Applied to Health Sciences (CPASS), Faculty of Medicine, University of Montreal, Montreal, QC, H3T 1J4, Canada.
authors.forename: Bernard
authors.initials: B
authors.lastname: Charlin
authors.affiliation: Undergraduate Medical Education and Centre for Medical Education, McGill University, Montreal, QC, H3A 2T5, Canada.
authors.forename: Valérie
authors.initials: V
authors.lastname: Dory
mesh_terms: D003657:Decision Making; D004635:Emergency Medicine; D006801:Humans; D007407:Interviews as Topic; D010817:Physician-Patient Relations; D015203:Reproducibility of Results; D013850:Thinking; D035502:Trust
keywords: Clinical reasoning; Decision making; Patients’ labeling; Physician-patient relationship