Develop and evaluate these qualities to build trust within your practice.

Trust is the foundation of all successful human interactions. Our partners, our lovers, our friendships and even our relationships with vendors who cut our lawns or clear our plumbing.

This is even true in an ophthalmology clinic. Here, we’ll cover the key aspects of a trusting relationship, starting from a banal perspective first.

CONSISTENCY

You’ve had the same electrician for 10 years. Every time you call them for service they arrive on time, diagnose and treat the problem, charge you fairly and the problem stays fixed. You trust this electrician and don’t have much anxiety about how the electrical bits of your life are going to be handled in the future.

Let’s compare this to trust in a medical practice setting.

At a doctor-patient level, a place where we all cherish trusting relationships, we earn patient trust by seeing them on time, answering their questions truthfully, diagnosing and effectively treating their chief complaint and remaining on call for the next time they need help.

See the pattern?

Whether it is plumbers or physicians or, for that matter, our dearest friends, trust is built by delivering on promises over and over again.

The opposite of this is also obviously true.

Think about the employee you trust least. Chances are they hesitate to make commitments, or they make commitments and then disregard them. Their performance falls below agreed standards.

COMMUNICATION

As central as following through on commitments is to building trust, the most important back stop supporting commitments is communication. In the average clinic, supervisors, administrators and owners do not always adequately clarify expectations for the staff they oversee. As a result, these staff are conditioned by the lack of feedback to fall short again and again.

Most people don’t communicate as well as they could. But, as a leader, it is your obligation to be clear about your expectations and continuously provide feedback when your expectations are not met.

This can be accomplished by following basic rules of excellent communication and the more specific notion of “accountable” communication. These same rules apply to communicating to individuals or groups:

1. Be clear about the message you send. Know the outcome or goal you are setting prior to sending the message. Is the message clear only to you because you know the back story, or will it be clear to anyone hearing this message for the first time?
2. Be aware of your body language. It’s easy to send mixed messages. For example, asking for feedback about an issue while your arms and legs are crossed and you are not making eye contact, signals, “I don’t want to hear from you.”
3. Listen better. Give your full attention to the speaker. Be receptive to feedback.
4. Follow up. After the communication is shared, always ask if any clarification or additional information is needed.
5. So-called “accountable” communication embodies three simple precepts: no defensiveness, no withholding, no triangulation. Describing how to communicate and navigate using accountable communication could be an entire article on its own. But, for our purposes here with regard to trust, you can imagine that being defensive in conversation, withholding information and talking about a third party (while that party is not in the room) are all non-starters when it comes to building trust.

BALANCE

No human is perfect, so it is unreasonable for you as a leader to expect that even your best employee is going to follow through on 100% of their commitments to you. But, you also don’t want to accept such low trust-building performance standards that people are not motivated to give you their best work.

Do this experiment. Write down a list of the 10 people you trust most in your life. This list might include a spouse, business partners, the nurse director of your ASC and a handful of employees. Now for each of these people you have listed, write down what percentage of the time they follow through on their commitments to you (whether these are small, basic commitments such as showing up on time or major commitments like patient safety).

Now make a second list of people in your life who you trust the least. This list might include a new employee who is yet untested, the painter who never shows up or a friend who lets you down. Do the same exercise. Next to each name, write down the percentage of time that these less trustworthy individuals follow through on their commitments.

Do you see the pattern?

SELF-EVALUATION

Now take the previous exercise one step further. Think about what percent of the time you keep your commitments. As a business or clinical leader in your practice, everyone in your world — doctors, staff, and patients — have higher expectations of you than they would of a lower-ranked member of the team.

What can you do with this information? Several thoughts come to mind.

• Examine your own trustworthiness. That’s to say, look at the degree to which you follow through on your commitments. That includes not just your overt commitments to yourself and others but, as importantly, the commitments the team implicitly — and reasonably — expect of you.
• Review your relationships. Look at all of the people in your ophthalmic world — doctors, staff, vendors, lenders, landlords, advisors, referral sources — and ask yourself four questions:
  1. Are we each setting appropriate standards for the commitments we make to each other?
  2. Are we each communicating these standards and providing feedback?
  3. Are any of us applying a higher standard than would be fair ... or a lower standard than would be effective?
  4. Are there any individuals in this web of relationships whose trustworthiness, follow through and timeliness fall below the minimum standards we need to run the company?

These evaluations are not easy. When we run through this question set with our clients, they will sometimes have an “aha” moment when they realize that important members of their team may never be deserving of trust — or that they as practice leaders have not yet created sufficient trust through their actions. OM

Corinne Z. Wohl, MHSA, COE, is president of C. Wohl & Associates, Inc., a practice management consulting firm. Corinne earned her Masters of Health Services Administration degree at The George Washington University and has over 30 years of hospital, physician practice management and management consulting experience. Her latest book, co-authored with John Pinto, is “UP: Taking Ophthalmic Administrators and Their Management Teams to the Next Level of Skill, Performance and Career Satisfaction.” For information on how to purchase this book or other inquiries, she can be reached at czwohl@gmail.com or 609-410-2932.

John Pinto is the founder of J. Pinto & Associates, Inc., an ophthalmic practice consulting firm established in 1979. He is the most published author in the world on the subject of ophthalmic management and economics. The firm serves organizations worldwide, ranging from solo practices to high-volume market leaders, teaching centers and medical product companies, providing strategic planning, financial benchmarking and analysis, operations enhancement and marketing counsel. He can be contacted at pintoinc@aol.com or 619-223-2233.