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Do Your Doctors and Management Team Trust One Another?

Presented by INTEGRATED Healthcare Strategies, as authored by
William F. Jessee, MD, FACMPE, Senior Vice President and Senior Advisor 

Relationships between physicians and hospital administrators have a checkered past.  In some cases, the two groups have forged close, productive relationships that help their organizations succeed in the face of challenging economic and environmental conditions.  However, in a significant number of other circumstances, the relationships have varied from “strained” to “toxic”—producing a negative impact on the organization.

As healthcare organizations undergo a transformation from a volume-driven delivery system to one that rewards value higher than volume, the need for close physician-administrator teamwork has never been greater.  One of the essentials for such teamwork is an atmosphere of mutual trust between the two groups.

Trust in organizations is based more on the actions of the parties than on any policy, strategy or other written expression of intent.  Trust is based on four key elements:

  • Predictability:  Trust means being able to predict what other people will do and what situations will occur.  If we surround ourselves with people we trust, then we create a safe present and an even better future.
  • Value Exchange:  Trust means making an exchange with someone when you do not have full knowledge about them, their intent and the things they are offering to you.
  • Delayed Reciprocity:  Trust means giving something now with an expectation that it will be repaid, in some unspecified way, at some unspecified time.
  • Exposed Vulnerabilities:  Trust means enabling other people to take advantage of your vulnerabilities—but expecting that they will not do this.

Management guru, Peter Drucker, has made a number of interesting observations about the role of trust in highly productive organizations:

“The leaders who work most effectively, it seems to me, never say ‘I.’  And that's not because they have trained themselves not to say ’I.’  They don't think ‘I.’  They think ‘we.’  They think ’team.’  They understand their job is to make the team function.  They accept responsibility and don't sidestep it, but the  ‘we’ gets the credit.  This is what creates trust, what enables you to get the task done.”

Unlike other organizational assets, trust seems to grow rather than be depleted, when it is used.  Trust is also a psychological state in which a person intends to accept vulnerability based upon positive expectations of the intentions or behavior of another.  It’s a willingness to act on the basis of the words, actions, and decisions of others---rather than on promises or even contracts.  Trust is a key element in conflict resolution negotiation, enhanced cooperation, information sharing, and problem solving---all of which are essential management skills in today’s healthcare organizations.

See the sidebar content in this article for 10 steps that will increase trust in your organization, and 10 steps guaranteed to reduce or eliminate trust.  Ask yourself how your team rates, and how you could do better. 

About the Author

William F. Jessee, MD, FACMPE, is a Senior Vice President and Senior Advisor with INTEGRATED Healthcare Strategies.  Dr. Jessee may be contacted by calling 612-339-0919 or emailing

About INTEGRATED Healthcare Strategies

For more than 30 years, INTEGRATED Healthcare Strategies has provided  consultative human-capital services to clients across the healthcare spectrum, including community and children’s hospitals, academic medical centers, health networks, clinics, and other healthcare-related organizations. Our expert consultants and nationally recognized thought-leaders help organizations achieve their business goals by ensuring top talent is attracted, retained, and engaged while measuring and maximizing human and organizational performance. With tailored solutions that extend well beyond single services, INTEGRATED offers the knowledge, guidance, insights, and alignment that organizations need to not only survive the rapidly changing healthcare environment, but to succeed in it. Exclusive to Healthcare, Dedicated to People.(sm)

Visit INTEGRATED Healthcare Strategies online at , or view our blog at

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