Table 2

Quotations supporting origins of patient–physician mistrust

Perceptions of injustice driving patient–physician mistrust(1) “Now everything is guided by economics. For physicians, hospital salaries can't come close to matching money from kickbacks and commissions. Maybe because his wallet grows, he is willing to engage in practices that violate his own professional ethics so that he can increase his own profits.”—Patient
(2) “[To a physician, the patient's] life is only worth several hundred yuan [tens of GBP]. In China, a person's life is just not worth that much. So as a physician if you save things that do not have that much worth, then your income will be low.”—Physician
(3) “You will find that when some patients see the doctor, they carry with them an extremely distrustful, hostile, and negative tone of speaking. These patients lay it out: newspapers are talking about the violence, hospitals are not to be trusted, and doctors are the worst. If you see a hundred patients and only see one distrustful patient, it matters. It slowly influences your perception of patients.”—Physician
High expectations from patients(1) “The biggest problem is the information between patients and physicians is asymmetric. Physicians have too much information and patients have too little. And physicians’ information is very systematic, while patients’ information is disorganized. This information inequality can cause many conflicts.”—Physician
Physicians lack training in medical communication and humanities(1) “[Health professional education] It's just taught according to the book line by line, it's very rigid and dogmatic. For example, patient-doctor communication isn't sufficient. Actually at the bedside we learn a lot of these kinds of communication skills. But the kinds of communication skills we were taught in school are not the kinds of skills we can apply.”—Nurse
(2) “Resolving the physical illness makes the patient feel satisfied. But if you're also able to deal with the psychological issues, it would make everyone better off. There are some people whose medical skills you can't deny but their temperament and communication skills impede their work.”—Physician