Trust in the workplace: Taking the pulse of trust between physicians and hospital administrators
Trust, the mutual confidence that one party in an exchange will not exploit the vulnerability of the other, is a cornerstone of effective collaborative relationships. Trust, defined as tested expectations, creates a shorthand which simplifies and cuts through clutter, allowing the real work to unfold. When co-workers trust each other, they are more able to take risks, make better decisions, and manage the uncertainty of the future.
The immense changes in the health care industry have had profound effects on the dynamics of trust between physicians and administrators. Market forces are driving individual physicians and administrators to collaborate in new ways which make possible the development of trusting relationships. However, what promotes trust among individuals from groups with a history of conflict who are suddenly forced to cooperate, is not well understood. This dissertation reports on a qualitative exploration of the development of reciprocal trust between six physician and administrator dyads who have been collaborating in unprecedented ways.
The findings suggest a strong connection between the purpose of the pairs' collaboration and the type of trust developed. Three types of trust were identified. "Durable trust" developed between pairs in long term functionally related relationships. "Shared results trust" developed between pairs involved in forming joint ventures and "shared adversary trust" developed between pairs who united to negotiate with a common adversary. These distinctions allowed a superordinate form of trust that was process driven to be distinguished from subordinate forms of trust that were goal oriented. There was also some indication that power rather than gender dynamics impact trust development. Administrators that were perceived to be more powerful were trusted more than those perceived to have less organizational influence.
This dissertation adds to the discourse on trust both theoretically and practically. Implications of these findings for the growing literature on trust in the workplace are offered. Finally, a fundamental assumption of this investigation is that trust building requires different skills depending on the purpose of the relationship. A compendium of practical information about how people who work together can develop more trust-filled collaborations is offered.
0624: Occupational psychology