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15 Ways to Eliminate ?Trust?In Health Care Organizations.

By Greg Piche'

Trust" can be defined as confidence in the integrity, ability, character and truth of a person or thing. It is a dangerous commodity in a health care setting. Remember as the poet said,

As contagion of sickness makes sickness, contagion of trust makes trust.

Marianne Moore, In Distrust of Merits (1941) Trust is a frightful tool in the hands of the wrong party bent on influencing events.

A small dust of earth that walks so arrogantly, trust begets power and faith is an affectionate thing.

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. Trust can be contained and even eliminated in any labor intensive organization by following a few simple rules. Here they are:

1. Keep your focus on your self interest rather than diluting it upon your organization and its members. There can be only one number one.

2. Always claim every success whether it belongs to you or not. Everybody loves a winner.

3. Chase the short-term goals that generate immediate returns. After all, you may not be here tomorrow and that might be a good thing.

4. Promise them anything whether you can deliver or not. Memories are short and it?s impolite to say no.

5. Maintain a firm hand in command and control. Everybody needs to know who is in charge of their future and fate.

6. Accept no responsibility for failure. Nobody likes a loser. Make sure that it is adequately punished to stomp out unnecessary risk.

7. Carefully limit the authority of those around you so that they know that they must respond to the strings that you pull.

8. Divide and conquer by identifying and rewarding your favorite people. Loyalty must have its perquisites and to the victor belong the spoils.

9. Punish those that demonstrate free thinking and independence. They need to get on the same page as the rest of the team. That kind of conduct can be disruptive.

10. Keep hidden agendas hidden until you need them. Transparency gets in the way of political pragmatism.

11. Announce principles and values for others to follow but provide yourself dispensation because after all you are in charge or on your way up.

12. Ignore or minimize the contributions of the "others" so that they do not get a leg up on "us." Make sure you can identify "them" that are opprosed to "us" so that we can over time squeeze them out of the organization.

13. Keep people on their toes by keeping organizational goals fuzzy and constantly changing, making it more difficult to focus responsibility. You can?t be a target if you are not responsible and your contribution is not measurable.

14. Reaching consensus is a waste of time. Tell people where the organization is going and brook no dissent. Get on the bus or off the boat.

15. Reward mediocrity because it is non-threatening and comfortable. Tie others to failures and punish them quickly to minimize the damage.

Following these prescriptions you will find an effective antidote to the menace of trust in your health care organization. Good luck and God speed.

Full post as published by Healthcare Law Blog on January 13, 2009 (boomark / email).