Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
KevinMD
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking
KevinMD
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking
  • About KevinMD | Kevin Pho, MD
  • Be heard on social media’s leading physician voice
  • Contact Kevin
  • Discounted enhanced author page
  • DMCA Policy
  • Establishing, Managing, and Protecting Your Online Reputation: A Social Media Guide for Physicians and Medical Practices
  • Group vs. individual disability insurance for doctors: pros and cons
  • KevinMD influencer opportunities
  • Opinion and commentary by KevinMD
  • Physician burnout speakers to keynote your conference
  • Physician Coaching by KevinMD
  • Physician keynote speaker: Kevin Pho, MD
  • Physician Speaking by KevinMD: a boutique speakers bureau
  • Primary care physician in Nashua, NH | Doctor accepting new patients
  • Privacy Policy
  • Recommended services by KevinMD
  • Terms of Use Agreement
  • Thank you for subscribing to KevinMD
  • Thank you for upgrading to the KevinMD enhanced author page
  • The biggest mistake doctors make when purchasing disability insurance
  • The doctor’s guide to disability insurance: short-term vs. long-term
  • The KevinMD ToolKit
  • Upgrade to the KevinMD enhanced author page
  • Why own-occupation disability insurance is a must for doctors

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

  • Rural emergency medicine in New Mexico: a physician’s firsthand account

    Sarah Bridge, MD
  • What the folinic acid retraction means for autism treatment

    Timothy Lesaca, MD
  • The pause medicine never taught us to take

    Mary Wilde, MD
  • How naming grief can restore meaning in medical practice

    Patrick Hudson, MD
  • The honest broker in pediatrics: Building the medical home

    Ronald L. Lindsay, MD
  • MOC patient outcomes: Why recertification doesn’t guarantee quality

    Brian Hudes, MD
  • Most Popular

  • Past Week

    • Missed diagnosis visceral leishmaniasis: a tragedy of note bloat

      Arthur Lazarus, MD, MBA | Conditions
    • Sabbaticals provide a critical lifeline for sustainable medical careers [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why Medicare must cover atrial fibrillation screening to prevent strokes

      Radhesh K. Gupta | Conditions
    • Menstrual health in medicine: Addressing the gender gap in care

      Cynthia Kumaran | Conditions
    • Beyond Flexner: Why we must rethink medical training reform

      Ravi Agarwala, MD | Education
    • Medical bankruptcy: the hidden cost of U.S. health care

      Richard A. Lawhern, PhD | Conditions
  • Past 6 Months

    • Missed diagnosis visceral leishmaniasis: a tragedy of note bloat

      Arthur Lazarus, MD, MBA | Conditions
    • Alex Pretti: a physician’s open letter defending his legacy

      Mousson Berrouet, DO | Physician
    • Health care as a human right vs. commodity: Resolving the paradox

      Timothy Lesaca, MD | Physician
    • The American Board of Internal Medicine maintenance of certification lawsuit: What physicians need to know

      Brian Hudes, MD | Physician
    • Why voicemail in outpatient care is failing patients and staff

      Dan Ouellet | Tech
    • AI-enabled clinical data abstraction: a nurse’s perspective

      Pamela Ashenfelter, RN | Tech
  • Recent Posts

    • Beyond Flexner: Why we must rethink medical training reform

      Ravi Agarwala, MD | Education
    • Rural emergency medicine in New Mexico: a physician’s firsthand account

      Sarah Bridge, MD | Physician
    • Trauma reactivation: Why news headlines trigger past abuse

      Barbara Sparacino, MD | Conditions
    • Ambiguous billing rules threaten every doctor in practice [PODCAST]

      The Podcast by KevinMD | Podcast
    • Deprescribing in health care: Why less medication can be more

      American Medical Association & John Whyte, MD, MPH | Meds
    • What the folinic acid retraction means for autism treatment

      Timothy Lesaca, MD | Physician

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

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Missed diagnosis visceral leishmaniasis: a tragedy of note bloat

      Arthur Lazarus, MD, MBA | Conditions
    • Sabbaticals provide a critical lifeline for sustainable medical careers [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why Medicare must cover atrial fibrillation screening to prevent strokes

      Radhesh K. Gupta | Conditions
    • Menstrual health in medicine: Addressing the gender gap in care

      Cynthia Kumaran | Conditions
    • Beyond Flexner: Why we must rethink medical training reform

      Ravi Agarwala, MD | Education
    • Medical bankruptcy: the hidden cost of U.S. health care

      Richard A. Lawhern, PhD | Conditions
  • Past 6 Months

    • Missed diagnosis visceral leishmaniasis: a tragedy of note bloat

      Arthur Lazarus, MD, MBA | Conditions
    • Alex Pretti: a physician’s open letter defending his legacy

      Mousson Berrouet, DO | Physician
    • Health care as a human right vs. commodity: Resolving the paradox

      Timothy Lesaca, MD | Physician
    • The American Board of Internal Medicine maintenance of certification lawsuit: What physicians need to know

      Brian Hudes, MD | Physician
    • Why voicemail in outpatient care is failing patients and staff

      Dan Ouellet | Tech
    • AI-enabled clinical data abstraction: a nurse’s perspective

      Pamela Ashenfelter, RN | Tech
  • Recent Posts

    • Beyond Flexner: Why we must rethink medical training reform

      Ravi Agarwala, MD | Education
    • Rural emergency medicine in New Mexico: a physician’s firsthand account

      Sarah Bridge, MD | Physician
    • Trauma reactivation: Why news headlines trigger past abuse

      Barbara Sparacino, MD | Conditions
    • Ambiguous billing rules threaten every doctor in practice [PODCAST]

      The Podcast by KevinMD | Podcast
    • Deprescribing in health care: Why less medication can be more

      American Medical Association & John Whyte, MD, MPH | Meds
    • What the folinic acid retraction means for autism treatment

      Timothy Lesaca, MD | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today

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

  • Terms of Use | Disclaimer
  • 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...