信与疑之间——民众对医生“反常”信任的实证分析

Between Trust and Distrust: An Empirical Analysis of Citizen’s Abnormal Trust in Doctors

信任为良性医患关系之必需。本文呈现了民众对医生群体的"反常"信任:民众对医生总体信任度较高,但对其医术、医德缺乏信任。为何会存有这种信任度差别?本文发现:中国医生职业信任主要源于民众对国家医疗制度的认同;医术、医德对医生信任具有塑造作用,但制度信任对其塑造力具有强烈的替代作用;制度信任会促进民众对医生抽象层面和具体层面的信任反差。通过对职业与国家关系的讨论,本文有助于理解复杂医患关系的形成机制。

Trust is a necessity for healthy doctor-patient relationship.This article analyzes the"abnormal"trust of the public in doctors:the public has a high overall trust in doctors,but lack trust in their medical skills and professional ethics.How to explain the coexistence of high and low levels of trust?We find that the professional trust of doctors in China mainly comes from the public’s recognition of the national medical system.Medical skills and professional ethics have a shaping effect on trust in doctors,but institutional trust has a strong substitution effect on its shaping power.A trust contrast between the abstract level and the concrete level is more likely to exist,as people give more recognition to the medical system.Through the discussion of the relationship between profession and state,this article helps to understand the formative mechanism of the complex doctorpatient relationship.