The price of trust: determinants of trust in physicians across 30 countries

This study examines the determinants of trust in physicians in 30 countries, focusing on general trust, perceived competence, and fidelity (defined as prioritizing patient welfare over profit). Using 2021 ISSP data combined with macro-level indicators such as the Human Development Index (HDI), health expenditures, and public–private funding preferences, the analysis explores how individual experiences and healthcare system characteristics shape trust. Results show that trust is strongly linked to confidence in the healthcare system and satisfaction with doctor visits, while socio-demographic factors and personal health experiences also play an important role. At the macro level, higher HDI is associated with greater trust, whereas higher out-of-pocket payments and healthcare commodification reduce it. Total health spending alone does not reliably increase trust, highlighting the importance of equity and efficiency. Overall, trust in physicians emerges as a multidimensional, context-dependent phenomenon shaped by both interpersonal and institutional factors.