Could Trusting Your Doctor Impact Your Health in America?

Discussion Tips

A better understanding of how individuals of different racial and ethnic backgrounds experience and view the medical care system could impact the health of a population. A better causal model that accounts for these perceptions might allow for better design of care systems and a greater appreciation of these perceptions might affect how individual clinicians interact with patients.

Discussion Questions

• What question is asked by this study and why does it matter?

• How does this study advance beyond previous research on this topic?

• How strong is the study design for answering the question?

  • o. What are the benefits and weaknesses of the survey design and administration?

  • o. What are the potential biases created by the survey design?

  • o. What confounding variables are present within the study?

    • ▪ What is the difference between a moderator and a mediator? Which of these should be controlled for in a regression analysis?

    • ▪ What is endogeneity? What happens to a model if there is endogeneity built into a model?

  • o. What type of model did the author’s use? What are the assumptions of a multinomial logistic regression? What’s the difference between ordinal and multinomial logistic regressions?

• To what degree can the findings be accounted for by:

  • o. How the main outcome variables were measured?

• What findings do you notice in the bivariate analyses (Table 3)? How do these compare to the multivariable model?

  • o. Do you think reporting having a primary care physician is a cause and/or effect of medical mistrust? How might this impact our causal model?

  • o. What’s the difference between a point estimate and a confidence interval?

• How comparable is the study sample to similar patients in your practice? What is your judgment about the transportability of the findings?

• What contextual factors are important for interpreting the findings?

  • o. How would you gauge the potential benefits and harms of the study?

• How might this study change your practice? Education? Research?

• Who are the constituencies for the findings, and how they might be engaged in interpreting or using the findings?

• What are the next steps in interpreting or applying the findings?

• What researchable questions remain?