Intended for healthcare professionals


The power of trusting relationships in general practice

BMJ 2021; 374 doi: (Published 22 July 2021) Cite this as: BMJ 2021;374:n1842
  1. Martin Marshall, chair
  1. Royal College of General Practitioners, London, UK
  1. Martin.Marshall{at}

Relationship based care remains a fundamental feature of safe, effective practice

Every medical specialty prides itself on the tools it uses to ply its trade. Physicians have their stethoscopes, surgeons their scalpels, radiologists their scanners. General practice, with its commitment to the humanities, claims a different sort of tool—a trusting relationship with patients. This essential tool is currently under threat because of workload pressures and lack of understanding by policy makers.1

This matters. When a GP sees a patient they know and there is mutual trust it’s easier to avoid prescribing unnecessary antibiotics and easier to reach agreement with the patient that they don’t yet need a scan for their back pain or to see a dermatologist for their rash. And patients are more likely to disclose relevant background information such as a history of sexual abuse or a truthful assessment of their alcohol consumption.

Research evidence supporting the benefits of trusting relationships is growing, and though mostly observational, the findings are consistent.2 Trusting relationships between patients and their …

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