The 11-item Trust in Physician Scale, described earlier, was modified slightly in the current study. One item, "My doctor is a real expert in taking care of
medical problems like mine" was modified to read, "My doctor is well qualified to manage (diagnose and treat or make an appropriate referral) medical
problems like mine," to be appropriate for the primary care setting. The wording of all 11-items is provided in the Results section. In a pilot study using
this slightly modified scale in 193 consecutive adult patients at a university-based primary care clinic, the distribution of Trust in Physician Scale scores
was skewed, with a mean of 78.9 when transformed to a 0 to 100 scale. Eighteen percent of patients scored 100 (the maximum). The labels were,
therefore, changed from the original (1 = strongly disagree; 2 = disagree; 3 = uncertain; 4 = agree; and 5 = strongly agree) to (1 = totally disagree; 2 =
disagree; 3 = neutral; 4 = agree; and 5 = totally agree) and the scale readministered to 70 additional patients from the same setting. The revised
response scale yielded a lower mean score (74.7) and only 5% of patients scored at the maximum. On this basis, the revised response scale was retained
for the main study, even though the difference in mean scores was small and was not statistically significant after adjusting for age and gender
differences between the two pilot study populations.