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Grand Stewards of Trust in Health Care: Where it Begins

“Trust is like blood pressure. It’s silent, vital to good health, and if abused it can be deadly.” Frank Sonnenberg Author of Follow Your Conscience


In the last few weeks I have had some interesting, but revealing conversations. These conversations have provided a lens into the fragile trust balance that exists in our country. On paper it may have appeared that these conversations couldn’t have taken place with two more different individuals. One was a former youth pastor. The other, a leader in a major international company. Both voiced concerns about COVID-19, the vaccine itself and the plan for vaccine distribution.

The former pastor shared that he was certain he would not take the vaccine. He expressed concerns over vaccines in general. He cited distrust with the government and the medical community due to historic injustices and current sentiments coupled with impending concerns about liberty. The industry leader expressed pro-vaccination attitudes but also had concerns toward vulnerable communities and tragic treatment they have suffered at the direction of the government and medical community.


The goal of this 5-part series is to promote positive ways to reduce the trust deficit and increase the education and acceptance rate for the COVID-19 vaccination specifically, and to change attitudes toward medical research and health care in general.


What became clear in these conversations wasn’t so much that it mattered how these men reached their conclusions, but that they HAD reached these conclusions. Their conclusions aren’t much different from those that exist throughout our communities. Their conclusions and concerns hinge on a fragile and wavering trust. It is our obligation and our duty as health care professionals to steward trust well. We really only get one shot. As Warren Buffet once said, “It takes 20 years to build a reputation and five minutes to ruin it.”

Like culture, distrust is often inherited. It began before our generation arrived on the scene and unless something is done, it will remain after we are gone. It is passed down through stories of first-person accounts, letters, articles and now even memes. It takes root and grows like a weed, because it is nurtured in the fertile ground of fear.

If left unchecked, distrust will choke out hope, opportunity, health and life. The only anecdote is empathic intentionality as a Grand Steward of Trust. Bob Vanourek, the author of Triple Crown Leadership said, “Trust is built when someone is vulnerable and not taken advantage of.” This couldn’t be truer. And this is exactly the position that we, as health care professionals, find ourselves. At the end of the day, everyone we interact with in our professional setting is vulnerable.


Vulnerability is not a construct defined by race or socio-economic status, though for many reasons these factors are leading indicators at times. In this sense, vulnerability reflects one’s ability to do for themselves. It is a measure of their susceptibility to harm and their willingness to show and share their hurts either physically or emotionally.



Each patient we have the privilege to interact with is cut from this mold. Each case represents someone who, if they could do for themselves to improve their own situation, would. The fact is they can’t. So, they turn to us, the experts to help them—whether that’s bandaging a leg, treating their cancer or giving them dignity in their final moments. They have invited us in to the vulnerability of their lives. In their weakness, they demonstrate the strength to ask for help. We CANNOT take advantage of them. This is precisely why we must be Grand Stewards of Trust.

Vulnerable people come in so many different shapes, sizes, colors and backgrounds. We cannot categorize them, setting up the potential and possibility of taking advantage of them by not recognizing them for the vulnerable positions they find themselves. This is where trust is eroded, eroded because we are often looking through the lenses in which WE choose to see the world and, as a result, projects in such a way that hinders our ability to empathetically understand.


In order to be Grand Stewards of Trust we must be present, promote credibility and demonstrate incredible hospitality.

1. BE PRESENT

Listen first, and then make people feel heard. Build meaningful relationships. Exercise empathic intentionality. Walk the journey with them.

2. PROMOTE CREDIBILITY

Expertise matters. Tell the truth and debunk myths at their roots. Acknowledging previous missteps provides a clear plan to improve with benchmarks for accountability. Be consistent with follow-up. Do what you say you will do.

3. DEMONSTRATE INCREDIBLE HOSPITALITY

Be kind. Be a good neighbor. Treat others as you want to be treated. Always.


This isn’t an impossible task. It simply requires us to do just a little more. It requires us to be courageous, to step into the void and shine the light of truth, kindness and empathy. If we do this well we will see the gaps in equity and care close and hesitation to public health solutions, such as vaccinations, crumble as trust rebuilds. In Part 2 we will explore Being Present as we walk the journey, block to block, together.



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