[Re]Building Trust

Why healthcare companies should be re[building] trust now.

Trust is more important than many leaders realize. I’ve been thinking about it in light of the 2019 allegations of wrongdoing in healthcare report and corresponding settlements being chalked up to the cost of doing business. 

The impact of wrongdoing whether it’s excessive charges, abusive billing practices and the mistreatment of patients and their data is likely having a much bigger impact than most healthcare executives realize. 

Healthcare Consumers

Healthcare companies undermined the trust Americans have in the system at a time when we are asking for more and need more data and engagement from patients and healthcare consumers. Granted there are other factors that have contributed to the mistrust felt more broadly but healthcare companies will need to rebuild that trust in order to transition into value based care models.


Employees of these companies are likely impacted too. The wrongdoing is not accidental but rather a function of the business practices that likely don’t align with the company’s stated values

How do employees reconcile what they believe versus what they do? They can’t reconcile it. The wrongdoing is likely contributing to the anxiety felt by the employees working within those companies. The impact of the stress and anxiety will only get worse until there is better alignment in the values and the work performed.


Did you know that companies with high levels of trust outperform their competitors by as much as three [3] times? Healthcare companies have relied too heavily on having a captive consumer. When people are sick, they surrender to the process to get better and deal with the fallout after the fact. 

That’s not going to work going forward. New approaches to medicine and healthcare services require participation from all consumers – not just patients. How is your company going to convince consumers to trust your organization and the process when there is no immediate need?


What is trust? The one common theme that I have found to describe trust is that trust happens when you’re willing to accept the risk of vulnerability or in other words, the risk of being harmed in some way. The perceived risk has to be lower than the probability of being harmed.

How do you convince someone to take the risk on your organization or you? Trust is earned by repeating actions that conveys trust. 

The book Trillion Dollar Coach, written about Bill Campbell’s work with leading Silicon Valley companies and executives, identifies five [5] key elements of trust:

  1. Keep your word: The commitment and/or fulfillment of one’s promises. Be accountable for mistakes, apologize and make amends when things go wrong.
  2. Loyalty: A strong feeling of support or allegiance. Establish clear boundaries and when you’re unclear about what’s okay and not okay, ask rather than ask for forgiveness after the fact.
  3. Integrity: The quality of being honest and having strong moral principles. Have the courage to practice your values and do what is right versus what is easy, fast and fun.
  4. Ability: The possession of the means or skill to do something. Avoid overpromising and underdelivering.
  5. Discretion: The quality of behaving or speaking in such a way as to avoid causing offense or revealing private information.

Trust can’t be won with one large gesture. It has to be built over time with actions that are consistent with the key elements of trust. Just remember – trust can be undermined faster than it is earned.

Be generous

Best advice from Dare to Lead for developing trust within an organization is for everyone to extend the most generous interpretation possible to the intentions, words, and actions of others.

Even if you believe that you are trustworthy, most only trust a handful of people. Chances are your assumptions about a situation, interaction or person are wrong. Default to truth but when in doubt, look for the data and trust the facts.

Engage Men

Studies published by HHS report that women consume about 12% more healthcare services than men because they are more likely to have regular checkups and doctor visits and take prescription medications. Men have typically delayed care until they have a problem that requires costly intervention – but with emerging technology and new options for care that could change.

My last post about what patients value was distilled from comments made by women. Consequently, I was left wondering whether men and women have shared values when it comes to healthcare or not. So I found a comparable healthcare service for men and read the YELP reviews for several providers. There were very few reviews written but there were some notable comments.

Data: One of the reviews described the charts, graphs and regression analysis a provider used to demonstrate the potential risks and outcomes of the specific procedure and the risks relevant to the author. The use of data in that way seemed to empower the author to make a decision about his care. Conversely, none of the reviews written by women referenced data or the use of data other than some basic stats about outcomes.

Advise: Another review was written by a man that underwent a procedure that didn’t result in a noticeable difference in his condition. In his review, he summarized his condition and provided advice for men with the same condition that may be considering treatment. Conversely, reviews of a similar nature written by women offered an opinion about their provider more often than advise about their treatment.

Given the limited reviews, I expanded my search to a medical group known to serve the same commercial patient population. There were about 60 reviews from men which accounted for about 25% of the total.

Cost: Almost every comment was a complaint about the cost and/or the incompetence of the billing staff. Authors used expressions like “watch your wallet” in reference to the high cost of routine services and the additional fees charged during annual checkups. Many reported discrepancies in trying to reconcile their provider statements with the remittance advice from their insurer. One even claimed to be “allergic” to the billing and collection practices of the provider. It makes me wonder whether men reconcile statements more closely than women or if they are just not as familiar with the documents and processes.

Granted it still isn’t enough information to draw definitive conclusions about what men value in the context of healthcare. However, it was enough to spur thought about how to engage men in their health in ways that could help reduce their cost of care and the potentially the care of others in their family.

Digital Health: Following the NIH annual exam recommendations, much of the annual exam for men could be completed using emerging digital health solutions in the near future.

Provider Portals: Data from the digital health solutions offer providers an opportunity to build early relationships with men by providing them with their health risks and outcomes profile and reviews by procedure to empower men in decisions about their health.

Minute Clinics: Simple menus of services will make it easy for men to fulfill all the requirements of an annual exam especially now that prostate screening exams a thing of the past. Hard to understand bills and statements will likely be a thing of the past too.

High Deductible Plans: Men may become more influential in family decisions about health and healthcare consumption given that there is more at sake. More employers are offering high deductible plans with healthcare savings accounts and for some it will be the only option.

About the Author: Shannon Smith is a healthcare strategist with over fifteen years of experience helping companies achieve greater success. She has successfully led the transformation of ASCs and hospitals, helped technology and device companies with product and customer development and advised other professional firms on transactions.