Physician Health

5 ways to build physician trust as a wellness-centered leader

Georgia Garvey , Contributing News Writer

Research shows that workplaces in which physicians feel valued, have control over their workload and trust their leaders have less burnout and, consequently, less turnover. But for leaders looking to create mutual trust with the physicians in their organization, where do they start?

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“Within any health care organization, we will do a lot better if we focus on building and maintaining a culture of wellness. And that starts with our leadership,” Kevin Hopkins, MD, family physician and primary care institute vice chief for the Cleveland Clinic, said during an episode of the “AMA STEPS Forward® podcast” with Jill Jin, MD, an internist and senior physician adviser for the AMA.

During the episode, Drs. Hopkins and Jin discussed what it means to be a wellness-centered leader and how to build trust throughout an organization.

Wellness-centered leaders communicate, clearly and freely, whenever possible, Dr. Hopkins said.

“The meaning of silence, of radio silence, is really open to interpretation,” said Dr. Hopkins, who is also a senior physician advisor for practice transformation at the AMA. “We often interpret that to mean, ‘Well, they’ve forgotten about me, or they don’t care, or it’s not a priority,’ when in reality it just might be, ‘Hey, wheels are in motion.’”

That is why “it can be helpful to follow up on that, even if it’s just to say nothing’s happened yet,” he said, noting that “following up reliably communicates engagement, value and willing accountability.”

Once feedback is solicited, leaders need to be committed to taking the next step, said Dr. Jin.

“The most important thing that will make me feel more motivated to give feedback to leadership is if I believe that they are actually listening and that they will actually act on that feedback,” she said.

Dr. Hopkins agreed that actions matter more than words.

“I’ve known a lot of people in leadership positions that say the right things, but they don’t always do the right things,” he said. “They mean to do well, but they over-promise and under-deliver, and that is an enormous way to really break trust in a relationship. And then once you’ve broken it, it’s hard to get it back.”

It’s crucial that leaders help develop the physicians they lead, said Dr. Hopkins. This might include aiding them in moving their careers forward or finding out what inspires them. It’s also about constructive criticism, and how to give it.

Dr. Jin recalled a young colleague, newer in the practice, who had a meeting with a clinic leader who sat the woman down and said, “We need to figure out how to make you more productive.”

Instantly, the trust between the two was shattered, all because of a poorly delivered message.

“My colleague was just crushed,” Dr. Jin said. “She was absolutely traumatized and just felt so bad because she was already trying so hard and was already struggling so much.”

“It would have been much more effective to say: We see based on your productivity that you may be struggling. Tell me how things have been going. I want to help,” she noted.

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Trust is a two-way street. It’s harder for physicians to trust their leaders if they don’t feel trusted themselves. The micromanagement of schedules is one way that leaders can break trust.

“When you feel like every single appointment slot is being looked at, you’re being watched over by someone, the underlying assumption when that happens is that your leaders don’t trust you or they think you’re fundamentally lazy and not wanting to see patients,” Dr. Jin said. “If we’re blocking our schedule, it’s because we need to for work-life integration, to prevent ourselves from drowning.”

Wellness-centered leaders get results—for patients and for health care organizations.

“More fulfilled, more engaged, more valued caregivers deliver better care,” Dr. Hopkins said. And the right kind of environment also leads to gains in the bottom line.

“Leaders who can help their workforce feel valued and less burnt out by building trust—so not just listening, but also taking actions to make tangible changes when necessary—those are the ones who will lead their organization to success in that their clinicians will not turn over,” Dr. Jin said. “They will keep on seeing patients and their patients will get better care.”