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Thoughts on Leadership

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How To Make Yourself More "Trust-Worthy" With Your Physician Colleagues

In my last post on whether trust between physicians is possible, or necessary, I talked about how having trust or lacking trust both within interpersonal relationships and teams/organizations changes everything. In this discussion I assert that trust is indeed one of those "must haves" for anyone who desires to move up, be successful, or even be happy in their personal and professional lives.



From Stephen M. R. Covey's excellent book "The Speed of Trust", after exhaustive research and experience with individuals and organizations, here are the "truths" about trust - see what you think:

Truth #1: Trust Is Possible

Many people believe that trust is one of those things – either you have it or you don’t. But this has been shown to be simply not true. Trust is something that can be developed over time, and that has an element of contagion that will positively impact those around you. Trust can be effectively taught and learned, and it can become a leverageable, strategic advantage.


Truth #2: Trust Begins With You

Trust is not a “soft”, nice-to-have. It is hard, measurable, and concrete. It is one of the most powerful forms of motivation – we know that people want to be trusted and that they respond to trust. In your professional life as a physician, if you desire to enhance your interpersonal, communication or leadership skills, it is your job to get good at the thing that underlies (and can potentially derail) all of those things - establishing, extending, and restoring trust … You do this not as a manipulative technique to get what you want, but as the most effective way of relating to and working with others, and the most effective way of getting results.


Truth #3: Trust = Character + Competence.

The most important thing to remember when thinking about building your trust quotient, is that trust is function of two things:

  • Your character – which includes your integrity, your motive, your “intent” with people

  • Your competence – which includes your capabilities, your skills, your results, and your track record

Think of a physician who has a good character – he is a likable guy, has the best of integrity, and authentic motives … but if he doesn’t have the clinical competence or track record of capability, will you trust him with your patients? Or the converse – you have a colleague that is the most clinically competent physician around, but has always lacked personal integrity, doesn’t seem on the “up and up” with certain elements of her cases, or has unclear motives and seems to try to undermine you at every turn … would you trust her?

Both character and competence are vital – you cannot have trust without either one. Think about how you may be perceived in either of those areas – do you think others see you as “trustworthy”?


Truth #4: Trust is a Process

For you to start building your trust quotient and reaping the benefits of having a true “trust dividend” in both your personal and professional lives, it is important to recognize that trust is part of a continuum, a ripple effect that comes from what Covey calls the “5 Waves of Trust”. Changing trust – even within physician groups or healthcare organizations that have terrible track records in this area - starts from the inside out. The key is understanding and learning how to navigate these “5 Waves”:

  1. The First Wave – Self Trust: Where we learn to build the confidence we have in ourselves – in our ability to set and achieve goals, to keep commitments, to “walk our talk” – and also in our ability to inspire trust in others. The key principle underlying this wave is credibility, which has four “cores”: 1) Integrity (How Congruent Am I?), 2) Intent (What’s My Agenda?), 3) Capabilities (Am I Relevant?), and 4) Results (What’s My Track Record?). Physicians and healthcare leaders who excel in self-trust are those who firmly establish high credibility, high judgment, and high levels of influence with others.

  2. The Second Wave – Relationship Trust: Is about establishing and increasing the “trust accounts” we have with others. The key principle underlying this wave is consistent behavior, reflected in actions such as “talk straight” (i.e., tell the truth), “demonstrate respect”, “create transparency”, “show loyalty”, “deliver results”, “listen first”, “keep commitments”, “extend trust”, etc. The net result for physicians and healthcare professionals who build this wave is a significantly increased ability to generate trust in order to enhance relationships, build better teams, enhance true collegiality and achiever better results. As the saying goes, “together we are stronger”.

  3. The Third Wave – Organizational Trust: Deals with how leaders can generate trust in all kinds of organizations, as well as in teams and other microunits within organizations. The key principle underlying this wave is alignment, which helps leaders create structures, systems and symbols of organizational trust that both decrease or eliminate insidious and costly trust “taxes” and create huge trust “dividends” in their groups. For those of you who have worked with people you trusted – but in organizations you didn’t – or in a situation where the organization’s systems promoted distrust, you can certainly see the criticality of this third wave of trust.

  4. The Fourth Wave – Market Trust: Is the level at which almost everyone clearly understands the impact of trust. The underlying principle behind this wave is reputation, which affects everything, from how patients and community members think of your organization/practice, how they both “purchase” your services and how they refer others, how they give you the benefit of the doubt, and how they stay with you longer.

  5. The Fifth Wave – Societal Trust: Is about creating value for others and for society at large. The principle underlying this wave is contribution, where by “giving back”, you counteract suspicion, cynicism, and any inherited low-trust situations. You also inspire others to create value and contribute as well.

Depending on their roles/responsibilities, physicians and healthcare leaders may have more or less influence as they move out of each successive wave. But we all have extraordinary influence on the first two waves … which is where the work begins for anyone who wants to increase this critical competence.


Bottom-Line: Trust is a Win-Win-Win-Win-Win (physicians-colleagues-patients-organizations-community). To learn more about this, I highly encourage you to pick up Stephen M.R. Covey's book,"The Speed of Trust: The One Thing That Changes Everything" and read it.

If you have read it, I look forward to hearing your thoughts on it!

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