The Effect of Three Key Administrative Errors on Patient Trust in Physicians: Prescription Errors, Confidentiality Breaches, and Appointment Errors
Authors: Aita Tetsuro , Miyawaki Yoshia , Katayama Yu , Sakurai Kosuke , Oguro Nao , Wakita Takafumi , Yajima Nobuyuki , Gupta Ashwin B. , Kurita Noriaki 
Published: December 2024

AbstractImportanceUnderstanding how administrative errors, such as prescription errors, appointment scheduling errors, and patient confidentiality breaches impact trust in physicians is crucial for improving patient-physician relationships and healthcare outcomes.ObjectivesTo investigate the association between administrative errors, general trust in physicians and interpersonal trust in a physician.DesignCross-sectional study.SettingAn online panel survey targeting adults across Japan.ParticipantsAdults aged ≥20 years who had received treatment at least twice for non-communicable diseases within the past 6 months.ExposurePast experiences with prescription errors, confidentiality breaches, and appointment scheduling errors by personal physicians treating their non-communicable diseases.Primary Outcomes and MeasurementsGeneral trust in physicians and interpersonal trust in a physician were measured using the Japanese version of the Wake Forest Physician Trust Scale.ResultsAmong the 661 participants, nearly 14% reported experiencing at least one type of administrative error. Prescription errors were associated with a significant decrease in general trust in physicians (–9.78 points, 95% confidence interval (CI): –13.74 to –5.81). Confidentiality breaches had the most significant negative impact on interpersonal trust (–14.09 points, 95% CI: –24.35 to –3.83), followed by appointment scheduling errors (–13.56 points, 95% CI: –22.48 to –4.65). Mediation analysis revealed that the association between prescription errors and reduced general trust was partially mediated by decreased trust in personal physicians.Conclusions and RelevanceAdministrative errors during care for non-communicable diseases significantly undermine patients’ trust in physicians. Physicians should prioritise improving their practices, particularly regarding prescription errors, as these errors harm interpersonal relationships and have broader implications for the public’s perception of physicians.key messagesWhat is already known on this topicPatient trust in physicians has been conceptualised as two constructs: trust in personal physicians and trust in physicians in general. While administrative errors, including medication prescription errors, can cause physical harm to patients, the impact of such errors, along with issues like appointment scheduling errors and breaches of confidentiality, on trust in physicians, has not been fully explored.What this study addsThis study found that prescription errors were associated with a decline in general trust in physicians. Appointment scheduling errors and breaches of confidentiality were shown to undermine interpersonal trust in personal physicians. Additionally, loss of trust in personal physicians partially mediated the association between prescription errors and loss of general trust in physicians.How this study might affect research, practice or policyEnhancing administrative practices, such as ensuring accuracy in medication prescribing, improving appointment scheduling, and safeguarding patient confidentiality, could strengthen the physician-patient relationship on a personal level and pave the way for better future interactions with other physicians.