Background: Trust between doctors and patients is foundational to effective healthcare delivery. Communication behaviours of physicians have been identified as key antecedents of trust formation; however, empirical evidence from Indian healthcare contexts remains sparse. Objective: This study examines the impact of six physician communication strategies — active listening, empathetic communication, information disclosure, non-verbal cues, patient-centred communication, and shared decision-making — on doctor-patient trust and, consequently, on patient satisfaction in Indian outpatient settings. Methods: A sequential explanatory mixed-methods design was employed. Quantitative data were collected from 320 adult outpatients across government and private hospitals in three Indian cities using validated scales (WFPTS, PSQ-18, physician communication scales). Structural equation modelling (SEM) was used to test the proposed conceptual model. Qualitative data were gathered through 26 semi-structured interviews analysed using reflexive thematic analysis. Results: All six communication strategies significantly predicted doctor-patient trust (total R² = 0.61). Patient-centred communication (beta = 0.37) and empathetic communication (beta = 0.34) were the strongest predictors. Trust, in turn, strongly predicted patient satisfaction (beta = 0.69, p < .001). SEM confirmed model fit (CFI = 0.96, RMSEA = 0.049). Qualitative findings identified five trust-shaping themes: listening as trust currency, emotional validation, transparency, cultural congruence, and systemic barriers. Conclusion: Communication strategies are robust predictors of trust and satisfaction in Indian clinical encounters. Healthcare institutions should invest in structured communication training, ensure cultural and linguistic responsiveness, and address systemic barriers — particularly consultation time constraints — to strengthen the therapeutic relationship.