Introduction to Trust and Healthcare

[00:00:00] Stacey Richter: "Bonus Add-on to Episode 477, How to Earn Trust." 10 years ago I spoke with Charles Green.

[00:00:26] Stacey Richter: Welcome to this bonus add-on. I'm not gonna give much of an intro here, except to say, we've come a long way, baby. And also this short clip from the original show about trust is really a masterclass on what trust means and how to earn it.

Meet Charlie Green: The Trust Expert

[00:00:39] Stacey Richter: My guest in the show is Charlie Green from Trusted Advisor Associates. Ten years ago when this episode originally aired, he'd been doing his, as he calls it, trust thing for about 15 years. This means being focused on speaking. He's written a lot about trust consulting, doing workshops and training for corporate accounts on the subject of trust and trusted relationships in business.

To listen to this episode or read the show notes with mentioned links, visit the episode page.

He has also written three books on trust, the best known one called "The Trusted Advisor". Here is my conversation with Charlie Green.

My name is Stacey Richter. This podcast is sponsored by Aventria Health Group.

Welcome to Relentless Health Value Charlie. 

[00:01:14] Charlie Green: Thank you. Pleasure to be here. 

Challenges of Trust in Healthcare

[00:01:16] Stacey Richter: If I'm a provider and I know I need to now collaborate with peers or if I'm a payer and I really need to work with providers or get my providers to work with me and actually trust that my motives are pure.

Or the same thing with the pharmaceutical industry. How do we even start thinking about this? 

[00:01:34] Charlie Green: It is a tough one. There are some industries where it's a lot easier than in healthcare. I think for example, the accounting industry, which is basically if you fix individuals trustworthiness, you've got 80% of the battle done.

But in healthcare, in the healthcare literature and the medical magazines, you know better than I do there are consistent cross currents of potential conflict of interest and so forth. It's not easy. 

Four Principles of Organizational Trust

[00:01:56] Charlie Green: But within that context, there are certain organizational trust components, and I'll list four trust principles that if you can think about them and apply them in your interactions with other organizations, they will help.

And very simply, they're systematically, make sure you're focused on the other person, not yourself. That's number one. Call it client focus.

Number two is collaboration, meaning cultivating a mindset that you're really on the same team. You've really got the same objectives here. You're not competing with each other.

Number three, don't focus on transactions. Do focus on relationships. Never think that you're involved in a one-off situation. Always think, what if this happened 10 times in a row? And finally, practice transparency as a default instead of obfuscation and accept where it's illegal, which it is sometimes, or where it's hurtful, which it also is sometimes.

So client focus, collaboration, long-term, and transparency. If you look at all your interactions with other organizations from those perspectives and do the best you can to push on each of them, that will begin to help. 

Addressing Trust Issues in Healthcare

[00:02:53] Stacey Richter: That just brings into stark focus how difficult this is gonna be for the health industry. Because if I tick down this list, hopping over client focus for a sec. But if we get to collaboration, I mean, that's always been sort of

[00:03:09] Charlie Green: That's tough. 

[00:03:09] Stacey Richter: Well, it's always been an issue because exactly as you state, oftentimes there's conflicts of interest. And oftentimes there's this very much zero sum game, either real or perceived. 

[00:03:20] Charlie Green: Right.

[00:03:20] Stacey Richter: So that's one thing. Then the focus on the transaction, I mean, one of the things I know for a fact that has happened over the years is that it has become incredibly transactional. It's all about kind of, you know, selling the pill and less about how are we gonna work together. And then lastly, with transparency, and everyone's holding their cards to their vest and nobody actually even understands what the others' true motivations are.

[00:03:46] Charlie Green: And yet, those are the things that have to happen. If you take collaboration, for example, you have got to step outside this and say, look, we have been thinking for years about zero sum interest here. And it's obvious there are some ways in which we're gonna wrap it a zero sum game, but both of us are stuck in that zero sum game, and both of us are gonna get screwed by it if we can't think our way out of it.

So let's collaboratively think about this prison that we find ourselves in, and how can we collaboratively begin to work on ways to get out of it. 

[00:04:12] Stacey Richter: I do think that also could revolve around being really creative and coming up with creative solutions that work for both parties, which might not be the original goal that either party had. 

[00:04:30] Charlie Green: I'm sure that's right.

[00:04:31] Stacey Richter: But now okay, so we've lost our trust. How do we get it back? 

[00:04:35] Charlie Green: I think you can say one thing clearly. It has to start at the personal, not the institutional level. And I think you know what each of us can do individually is actually quite a bit.

If I had to give one really gross, simple piece of advice, it would be go out and do the best that you can to listen to other people. Be curious about them. Listen to them not to learn things from them or to do a brain suck of whatever you can find out, but listen to them as a form of respect. As a form of paying attention, as a form of homage to another human being, and you'd be amazed at the response that you get when you behave that way.

Even in matters of a you know, five or 10 seconds within a conversation. If you truly listen to other people in a sense of kind of valuing them, their natural reciprocal response is to pay attention to you in return. It's just, it is how people work. It's how we do things.

I reach my hand out to shake hands with you and smile at you. Guess what you do? You reach out and shake my hand and smile back at me. And at that trivial level, you add it up, and you end up being able to have dialogues with other people.

Well, some of those people are from the other part or another part of the healthcare system. And if you can begin to have a dialogue with each other, you can begin to say, listen, we got institutional problems here too.

How do we deal with this? How can we set up more collaborative systems? But that's where I think it probably has to start.

It's not gonna start in Congress. It's not gonna start in great academic studies about the structure of the industry. Those have to happen. And those will happen. But the leadership thing I think has got to come from individuals.

A few people behaving in a determined kind of a way can have quite an outside impact. You don't have to wait for the CEO to do it. You don't have to wait for the incentive system to make it worth your while. You can be behaving in these ways and watch the ripple effects. They're quite, quite extraordinary.

The Role of Leadership in Building Trust

[00:06:15] Stacey Richter: When you were talking, it really occurred to me that leadership of organizations could be really important here. How many times have you, you know, gone into a business and seen some kind of credo on the wall that nobody pays any attention to? 

[00:06:27] Charlie Green: Right, right. 

[00:06:28] Stacey Richter: Or it's one thing for a leader to say, we want relationships.You know, we're concerned about the long term here, and then hammer to deliver the numbers. 

[00:06:37] Charlie Green: Yeah, exactly. 

[00:06:38] Stacey Richter: I know that it all starts from the individual and we talked about this earlier, but can leadership be kind of a force multiplier in this? You know, if leadership really embodies that trust equation and really makes their organizations understand the value of this trust, how much does that matter?

[00:06:56] Charlie Green: Yeah, we often hear how leadership, you know, makes a big difference and you can't do it if it doesn't lead with the CEO's office and all that sort of thing. What's unique about trust, I think, is that there's an outsized impact on the behavior of the CEO or the leader.

It's less about what they say, it's much more about what they do. So you'll find, I don't know, any leader or CEO that won't say, oh, we value relationships and customers and so forth. As you point out, you know, their next actions are often very cynically at odds with that.

Leaders who embody very personally the kinds of attributes that we've talked about have a huge impact. When people see a leader saying, you know, I don't know the answer to that, whoa. And it's okay to say you don't know. When people see a leader who actually listens and pays attention to a subordinate. And displays characteristics of empathy, it's just, it's remarkable.

You know, the older I get, the more I look at business and history and so forth, and the more I become convinced of the power of individual leaders, people, human beings really have an outsized impact.

You know, you watch the series, the Roosevelts that was on this, these past few weeks or something, and you realize what an outsized impact personalities have in positions of leadership. It's especially true with trust. So walk the talk turns out to be much more powerful in trust than almost anything else I can think of.

[00:08:14] Stacey Richter: So basically your advice is that regardless of who your CEO is, that if we want to improve our trust, we just simply need to work on ourselves.

However, if we are a CEO, then we need to really take a good, hard cold look at, are we trustworthy ourselves? 

[00:08:35] Charlie Green: Yep. 

[00:08:36] Stacey Richter: Because our influence will trickle down.

[00:08:39] Charlie Green: That's exactly right. We watch people whom we admire and respect are in positions of responsibility and we emulate or, and we judge them. What's the Gandhi phrase? Be the change you want in the world.

It's a great model. He is absolutely right in trust. 

Practical Steps to Improve Trust

[00:08:53] Stacey Richter: So we might have already covered this, Charlie, but if someone cleared their calendar and they've got three hours in this afternoon to do something to improve their score in the trust equation, what would you suggest?

[00:09:05] Charlie Green: It's listening with a sense of curiosity and respect to affirm the other person. I don't know what you call that. Call it empathetic listening. Call it affirmative listening, but it's different. I mean, if you go read the stuff that's out there, there are millions of things on listening and paying attention and body mirroring and all that stuff, but most of it's aimed at how do you get something for you out of listening to them.

And what I'm talking about is, is how do you simply give people a gift. A very fine gift of your attention? How do you pay attention? The phrase is interesting. How do we, it's something we pay. What that drives is this reciprocal behavior on the part of other people that goes right to the foundation of not only social etiquette, but business and relationships.

If you do X for me, I will do Y for you. We've come to think of that equation as being somehow loaded with quid pro quo and illegal and so forth. But the, if you do X for me, I do Y for you formula is at the heart of relationships. We do things for other people, not so that they will do things for us.

But the fact is that in so doing, they do do things for us. So go out and practice listening as a form of paying attention, you know, and then you gradually build up trying this, kind of listening on people in your life whom, who have much more control over you. Typically, the big three are, you know, your boss, your customer, and your spouse.

If you can listen to them in the kinds of ways that I just talked about, showing respect, being curious, you'll be astonished at the kind of powerful impact that can come right back at you. 

Conclusion and Contact Information

[00:10:29] Stacey Richter: Well, that is something I am going to work on today. So Charlie, how can people reach you? 

[00:10:36] Charlie Green: They can reach me at my website, "trustedadvisor.com", or if they happen to have a pencil C Green, that's cgreen@trustedadvisor.com.

[00:10:49] Stacey Richter: Thank you so much for being on the show today. 

[00:10:51] Charlie Green: It's been a pleasure too. Thank you.