Establishing trust, then, is a core element of the art of Medicine. It is so fundamental to success I wonder why it is not emphasized more explicitly in education and training. No doubt some physicians are more naturally gifted than others in the interpersonal skills that engender trust, but no physician-patient relationship can succeed without it.
So let me take a moment to describe the interpersonal behaviors that beget trust, the lecture I would give to medical students if this topic were placed in their curriculum, and the advice I would give to America’s leaders if anyone would listen.
First, be honest. Be consistently honest. Be impeccably honest. Tell the truth. One single lie, however insignificant, may dissolve a lifelong relationship. Second, be sincere. Say what you mean. Believe what you say. Show that you care. Most patients can sense insincerity when they feel it, even if you cannot tell how they know it. Third, be reliable – as dependable as the sunrise. Fulfill every commitment. Follow through on every pledge. Keep every promise. Trust requires credibility, and credibility comes from consistency. Once again, I am reminded of the value of the systematic approach.
I am also struck by how closely these attributes – honesty, sincerity, and reliability – track to what we call integrity. Maybe integrity is all you really need to build trust. That seems like such an obvious thing to say and such an easy thing to do. So why do we, physicians, sometimes fail to live up to that?
From The Ailing Nation, Chapter Three: Trust
Without a doubt, trust is the basis of all relationships. In fact, I would go so far to say that a relationship without trust is not a relationship at all, just a series of interactions. So how does one create trust between two parties? By displaying integrity: telling the truth, being sincere, and keeping promises. In other words, establishing credibility through words and deeds that show the other party that they can count on you. Unfortunately, trust is much easier to lose than it is to win. One broken promise or a single lie can doom a relationship forever. Hence, trust must be nurtured, cultivated, and carefully tended. But once trust is secured, the relationship soars. A doctor can convince a patient to undergo a lifesaving treatment. A business associate can sign a deal with a minimum of scrutiny. A spouse can sleep at night. And a national leader can change the world.
