Skip to content
  • About
  • Contact
  • Contribute
  • What Physicians Say
  • My Book
  • Careers
  • Podcast
  • Speaking
KevinMD.com — Social media's leading physician voice
  • All
  • Physician
  • Burnout
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • All
  • Physician
  • Burnout
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
    • All
    • Physician
    • Burnout
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • About
    • Contact
    • Contribute
    • What Physicians Say
    • My Book
    • Careers
    • Podcast
    • Speaking
KevinMD.com — Social media's leading physician voice
  • All
  • Physician
  • Burnout
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
    • All
    • Physician
    • Burnout
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • About
    • Contact
    • Contribute
    • What Physicians Say
    • My Book
    • Careers
    • Podcast
    • Speaking
  • About Kevin Pho, MD, Founder of KevinMD
  • Aging and dementia: what physicians say, in their own words
  • Artificial intelligence: what physicians say, in their own words
  • Be heard on social media’s leading physician voice
  • Cancer: what physicians say, in their own words
  • Children’s health: what pediatricians say, in their own words
  • Contact Kevin
  • COVID-19: what physicians wrote as it happened
  • Custom enhanced author page pricing
  • Diabetes and obesity: what physicians say, in their own words
  • Direct primary care: what physicians say, in their own words
  • DMCA Policy
  • End of life: what physicians say, in their own words
  • Establishing, Managing, and Protecting Your Online Reputation: A Social Media Guide for Physicians and Medical Practices
  • GLP-1 drugs: what physicians say about Ozempic and its successors, in their own words
  • Heart disease: what physicians say, in their own words
  • Immigration and medicine: what physicians say about immigrant doctors and immigrant patients, in their own words
  • KevinMD influencer opportunities
  • Medical errors: what physicians say, in their own words
  • Medical ethics: what physicians say, in their own words
  • Medical malpractice: what physicians say, in their own words
  • Medical school: what students and physicians say, in their own words
  • Mental health: what psychiatrists and physicians say, in their own words
  • Nursing: what nurses and physicians say, in their own words
  • Opinion and commentary by KevinMD
  • Opioids: what physicians and pain patients say, in their own words
  • Physician burnout speakers to keynote your conference
  • Physician burnout: what physicians say, in their own words
  • Physician Coaching by KevinMD
  • Physician keynote speaker: Kevin Pho, MD
  • Physician personal finance: what physicians say about their own money, in their own words
  • Physician Speaking by KevinMD: a boutique speakers bureau
  • Physician suicide: what physicians say, in their own words
  • Physicians and administrators: what physicians say about who runs medicine, in their own words
  • Primary care physician in Nashua, NH | Kevin Pho, MD
  • Primary care: what physicians say, in their own words
  • Prior authorization: what physicians say, in their own words
  • Privacy Policy
  • Private equity and corporate medicine: what physicians say, in their own words
  • Race and medicine: what physicians say, in their own words
  • Recommended services by KevinMD
  • Residency: what residents and attendings say, in their own words
  • Scope of practice: what physicians, nurse practitioners, and PAs say, in their own words
  • Subscribe to the KevinMD enhanced author page
  • Subscribe to the newsletter
  • Surgeons and surgery: what surgeons say, in their own words
  • Take-home messages: what physicians say when asked to leave one
  • Terms of Use Agreement
  • Thank you for subscribing to KevinMD
  • Thank you for upgrading to the KevinMD enhanced author page
  • The electronic health record: what physicians say, in their own words
  • Vaccines: what physicians say, in their own words
  • Violence against health care workers: what physicians and nurses say, in their own words
  • What physicians say: the KevinMD records
  • Women in medicine: what women physicians say, in their own words
  • Women’s health: what physicians say, in their own words

Beware of the potential harms of trust: 5 safeguards

Neil Baker, MD
Physician
August 25, 2019
Share
Tweet
Share

While “trust” sounds like it would be an inherently good thing to have between two people or in a team, that is not always the case. Depending on what “trust” means to you, it can also be harmful at times.

While it may not at first seem pertinent, driving in traffic can be a helpful metaphor for understanding different definitions of trust in the workplace.

A couple of years ago, I was rear-ended at a stoplight. I got very angry and leaped out of the car to confront the “reckless, inept” driver who hit me only to meet a tearful woman apologetic over the accident. She told me she had come from a medical appointment in which she had received bad news. Learning this, I was embarrassed at my impulsive road rage.

In the moment of stress, I leaped to flawed conclusions about the inherent reliability or trustworthiness of the other driver. Under stress or pressure, there is a strong tendency to treat trust as due to a personal trait of trustworthiness and make global, black or white judgments.

In the workplace, for example, when agreements appear broken, or we feel treated poorly we might leap to a global, negative judgment and tell a person “You are not trustworthy” or “I don’t trust you.” Or, this judgment might lead us to withdraw from communication. Either way, both actions can be experienced as disrespectful and provoke defensiveness, which harms collaboration.

In contrast, trust becomes less black or white if we see outcomes in specific situations as arising from complex, interacting factors. Breakdowns and mistakes are inevitable even when people are well-intentioned and skilled. From this perspective, trust is a state which is always changing and requires constant attention and adjustments from everyone involved to build and sustain.

In both driving and in the workplace, we are choosing to make ourselves vulnerable to the actions of others. There is no absolute, risk-free trustworthiness. In driving, to help deal with the risks, there are safeguards or ground rules to guide behavior (e.g., “stop when the light is red”). In the workplace, all too frequently, ground rules for work agreements are not clear or are confused over time by competing demands and priorities.

Here are five ground rules or safeguards that approach trust as a constantly changing state which must be jointly managed. While not meant to be comprehensive, this guidance serves as a foundation for strengthening team collaboration over time.

  1. Agree to assume everyone has good intentions.
  2. For each task, define shared goals, roles, priorities, and timelines — that is, establish clarity about what is being agreed to and who will do what by when.
  3. Define norms for communication, feedback, and decision making. For example, it is crucial that different views and troublesome issues are actively elicited and explored rather than debated or avoided. Feedback should emphasize referring to specific behaviors in specific situations as opposed to global judgments.
  4. Assure regular check-in times to see how things are going. Assume that misalignment, miscommunication, and mistakes will occur.
  5. Leaders need to assure clarity and consistent application of norms and activate performance intervention as appropriate when someone repeatedly will not follow them.

It is curious that some influential books on leadership and teamwork do not list the word “trust” in the index or as a major topic heading. Also, I have seen mission and values statements of highly successful organizations which do not include the word or mention it only very briefly. In these cases, terms such as fairness, respect, honesty, integrity, and psychological safety are used which have much overlap and interdependency with trust. The five ground rules for trust also help in building all of these qualities of relationship.

Working with trust is challenging because, in response to stress and pressure, we may cause harm by leaping to flawed conclusions about the personal trait of trustworthiness in others. In fact, trust is a constantly changing state dependent on the quality of safeguards or ground rules we mutually negotiate with others to manage risk.

Neil Baker is a physician and founder, Neil Baker Consulting and Coaching.

Image credit: Shutterstock.com

Prev

Should doctors give up on primary care?

August 24, 2019 Kevin 24
…
Next

Simple suggestions can make such a positive impact

August 25, 2019 Kevin 0
…

ADVERTISEMENT

Tagged as: Practice Management

< Previous Post
Should doctors give up on primary care?
Next Post >
Simple suggestions can make such a positive impact

 

ADVERTISEMENT

More by Neil Baker, MD

  • Why experience and skills are not enough

    Neil Baker, MD
  • Psychological safety in health care: simple, important, fragile

    Neil Baker, MD
  • Here’s why health care innovations stay secret

    Neil Baker, MD

Related Posts

  • Drug ads are a campaign against physician trust

    Judy Salz, MD
  • Beware of pseudoscience: The desperate need for physicians on social media

    Valerie A. Jones, MD
  • Building a bond of trust between patient and physician

    Michele Luckenbaugh
  • Beware of food sensitivity tests on Facebook

    Roy Benaroch, MD
  • Establishing trust with LGBTQIA+ patients

    Kristin Puhl, MD
  • Trust the process of medical school admissions

    Paul Lee and Samuel Wu

More in Physician

  • Choosing a limb lengthening surgeon requires accountability

    Hrayr Basmajian, MD
  • How to reassure patients: 5 steps beyond normal tests

    Devina Maya Wadhwa, MD
  • Setting boundaries as a physician doesn’t mean caring less

    Jerina Gani, MD, MPH
  • How emergency medicine decision making works under pressure

    Geoffrey Mount Varner, MD, MPH
  • Why I stay in emergency medicine: a dancer at nearly 100

    Howie Mell, MD, MPH
  • Distrust of science is inviting the Middle Ages back

    Tomi Mitchell, MD
  • Most Popular

  • Past Week

    • Retirement isn’t the end of medicine, it’s a second act [PODCAST]

      The Podcast by KevinMD | Podcast
    • The conflict of interest that discloses as nothing

      Martha Rosenberg | Medications
    • Surgical judgment: the skill no one sees from the gallery

      Mustafa Kemal Çalık, MD | Physician
    • Why haven’t ambient AI scribes boosted productivity?

      Karan Kanwar | Health Technology
    • Physician well-being is not an individual problem

      Heather Buckley | Conditions and Diseases
    • Burnout isn’t only about autonomy, it’s about your bank account [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Why CDC opioid guidelines get the overdose data wrong

      Richard A. Lawhern, PhD | Conditions and Diseases
    • Retirement isn’t the end of medicine, it’s a second act [PODCAST]

      The Podcast by KevinMD | Podcast
    • Sensory processing in autism and the brain’s volume control

      Josette Pelatan, PhD | Conditions and Diseases
    • What maternity care deserts cost a town

      Manisha Kaliaperumal | Health Policy
    • Why medicine needs a national physician license now

      Vaishali Popat, MD, MPH | Physician
    • A cold cost $945. The cost of primary care is broken.

      Susan Newman, MD | Physician
  • Recent Posts

    • Shift work and circadian rhythms shape the 24/7 workplace

      Deepak Gupta, MD | Conditions and Diseases
    • Paid for twice

      Physicians paid for G2211 twice. Most never bill it.

      Michael Duben, MD | Physician Finance
    • The next child

      Medicaid managed care and the case for mutual stewardship

      Steven Merahn, MD | Health Policy
    • Choosing a limb lengthening surgeon requires accountability

      Hrayr Basmajian, MD | Physician
    • Cited but never checked

      Why AI crisis advice may fail families facing psychosis

      Nicole Drapeau Gillen | Health Technology
    • How AI phone systems in health care create barriers

      Thuy D. Bui, MD | Health Technology

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

Leave a Comment

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Retirement isn’t the end of medicine, it’s a second act [PODCAST]

      The Podcast by KevinMD | Podcast
    • The conflict of interest that discloses as nothing

      Martha Rosenberg | Medications
    • Surgical judgment: the skill no one sees from the gallery

      Mustafa Kemal Çalık, MD | Physician
    • Why haven’t ambient AI scribes boosted productivity?

      Karan Kanwar | Health Technology
    • Physician well-being is not an individual problem

      Heather Buckley | Conditions and Diseases
    • Burnout isn’t only about autonomy, it’s about your bank account [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Why CDC opioid guidelines get the overdose data wrong

      Richard A. Lawhern, PhD | Conditions and Diseases
    • Retirement isn’t the end of medicine, it’s a second act [PODCAST]

      The Podcast by KevinMD | Podcast
    • Sensory processing in autism and the brain’s volume control

      Josette Pelatan, PhD | Conditions and Diseases
    • What maternity care deserts cost a town

      Manisha Kaliaperumal | Health Policy
    • Why medicine needs a national physician license now

      Vaishali Popat, MD, MPH | Physician
    • A cold cost $945. The cost of primary care is broken.

      Susan Newman, MD | Physician
  • Recent Posts

    • Shift work and circadian rhythms shape the 24/7 workplace

      Deepak Gupta, MD | Conditions and Diseases
    • Paid for twice

      Physicians paid for G2211 twice. Most never bill it.

      Michael Duben, MD | Physician Finance
    • The next child

      Medicaid managed care and the case for mutual stewardship

      Steven Merahn, MD | Health Policy
    • Choosing a limb lengthening surgeon requires accountability

      Hrayr Basmajian, MD | Physician
    • Cited but never checked

      Why AI crisis advice may fail families facing psychosis

      Nicole Drapeau Gillen | Health Technology
    • How AI phone systems in health care create barriers

      Thuy D. Bui, MD | Health Technology

Copyright © 2026 KevinMD.com | Powered by Astra WordPress Theme

  • Terms of Use Agreement
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Leave a Comment

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...