How Physician Communication Style Shapes Patient Trust: A Systematic Review.

Abstract

Research on physician communication and patient trust has expanded in recent years, yet the evidence remains fragmented across conceptualizations of communication, operationalizations of trust, research methods, and clinical and technological contexts. This systematic review synthesizes recent studies examining how physician communication styles are associated with patient trust in real physician-patient interactions. Following PRISMA guidelines, 13 studies published between January 2021 and July 2025 were identified from 5,730 records retrieved from English-language peer-reviewed journals. Across quantitative, qualitative, mixed-methods, and review-based evidence, physicians' communication styles-including information-giving, socio-emotional, partnership-building, paternalistic, and nonverbal approaches-were examined in relation to patient trust. Overall, clear information delivery, empathy, active listening, shared decision-making, and supportive nonverbal behaviors were generally associated with higher levels of patient trust, while directive or paternalistic communication showed more context-dependent effects. Using established multidimensional understandings of patient trust as an analytic lens, the review shows that communication-trust associations were shaped by clinical settings and digital or technological conditions. Taken together, the findings highlight key patterns and gaps in the literature and underscore the need for more rigorous and cross-cultural research, as well as communication training that emphasizes empathy and partnership to strengthen physician-patient trust.