The title is intriguing: Trust Matters. It's a new book written by two healthcare professionals, Michael Annison and Dan Wilford. Annison is president of the Westrend Group, a consulting company based in Denver. His first book, Managing the Whirlwind: Patterns and Opportunities in a Changing World, won the American College of Healthcare Executives' 1995 James A. Hamilton Award as "the book of exceptional merit in the field of healthcare or general management." He knows healthcare well. Wilford is president and chief executive officer of Memorial Hermann Healthcare System in Houston. He's been a respected leader in healthcare for years. In March 1997 he received the ACHE's Gold Medal Award as the nation's outstanding healthcare executive. These two savvy individuals offer one the best treatises on leadership I've read in some time.
The authors start by telling us why trust matters in the healthcare industry. They offer four reasons: "First, trust matters because we have exhausted the benefits of existing management theories about how we should treat each other at work." They argue that healthcare executives in many cases have adopted management theories from other industries. However, in doing so they have gotten away from focusing on people and instead have become infatuated with things like specialization, impersonal decisionmaking and hierarchical controls. "Second, trust matters because tidy organizational charts on their own won't enable us to accomplish what we need to do," the authors say. A lot of the organizational experimentation has delivered less than was expected. "Third, trust matters because it affects how we manage people." Simply ordering people to do certain things doesn't really cut it anymore. True leaders have to capture the hearts and minds of their colleagues so they are committed to a goal. "Fourth, trust matters in the relationships between healthcare professionals and the people they serve." Trust is important because patients think it's important. Countless cases of healthcare fraud and HMO horror stories have diminished trust in the industry.
Annison and Wilford then outline the seven elements of trust. They start with commitment. "We trust people who understand the meaning of commitment, and whose actions make it clear they are committed to something more than themselves." Familiarity is next. "We trust people and institutions when we believe we know them well enough to know they can be trusted." Then there's personal responsibility. "We trust people who are willing to take responsibility for their behavior." That's followed by integrity. "We trust people who are honest." They say a second aspect of integrity involves self-awareness-in other words, what you stand for and care about. Consistency is the next element. We all like people we can rely on, no matter what the circumstances. Communication and forgiveness/reconciliation follow. Open communication is essential to trust. And the willingness to forgive and forget also has its place in the equation. How can we get on with our objectives if we hold grudges?
The final element underlying the concept of trust, according to Annison and Wilford, is " . . . understanding that the essence of trust is spiritual and requires faith. Spirituality provides the basis for trust because it compels us to consider the morality of what we do."
Trust is critical in any relationship. None of us likes to work with people who can't be counted on. None of us likes to do business with organizations we don't believe are playing fair. Trust is the backbone of democracy. It's a tenet of being a decent human being. Unfortunately, it's taken for granted and squandered by cynical, self-serving individuals who deride morality and ethics as abstract, foolish principles. Trust comes into play no matter who we are or what we do.
It matters very much,
Charles S. Lauer