135. The Fundamental Currency of Physician Leadership - without this you are doomed to failure

Introduction: The Importance of Trust in Physician Leadership

In this episode, you'll discover the fundamental currency of physician leadership. It's the single most powerful influence on your professional relationships at work, up and down the chain of command. It's just as important to your leadership, skill, effectiveness, and satisfaction as money and credit are in the outside workings of the economy—a scarce resource you must guard at all times with all of your awareness. Once I show this to you, you will see it everywhere. It pervades the workplace, and hopefully you're in a positive balance. But I doubt it. Check it out.

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What is the Fundamental Currency of Leadership?

In this episode, you'll discover the fundamental currency of physician leadership, the currency that transacts between you and all of your direct reports, be it down the chain of command to your frontline workers or up the chain of command to your leadership. In either direction, the currency is the same. What am I talking about? I'm talking about the aspect of human relationships that is the key to influence, just like you use cash for purchases and to get what you want in the outside world, inside an organization, when leaders are interacting with each other or with their frontline workers, this is the currency that exchanges hands in order for us to work collectively in a positive, collaborative, creative, and enthusiastic manner.

What am I talking about? For heaven's sakes. Well, it's a five-letter word that you already know, and it begins with T. Five-letter word begins with T. What do you think the answer is, yeah. Well, it's Trust. Trust, the fundamental currency of leadership, is trust. And there's a trust account that sits between you and every one of your direct reports, up and down the chain of command. That account holds the amount of trust between them and you. Do they trust you? And how would you build trust in that account? Since you want to have a positive balance, something to draw on when you need it. How would you build a positive balance in the trust account between you and any one of your direct reports? Well, it's based upon regular interactions that are positive in nature, regular touches where you're not disciplining them and they're not in trouble.

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The Trust Test

The challenge is that in healthcare, we are so uniquely busy and preoccupied that in every organization I've ever consulted with and in every training—and I've trained over 40,000 doctors—I ask this question, hey, if your boss shows up unannounced on a day when you're seeing patients, is that a good thing? And immediately everybody in the whole room looks at each other and starts shaking their head and looking at the floor. No, if your boss shows up unannounced, let me ask you this, if your boss shows up unannounced, is that a good thing? The answer is usually no. The only reason they would show up unannounced is because, what? Because you are in what? Trouble. And if you are a boss that only shows up when people are in trouble, your trust account with your people is either zero or negative, and you will have a very hard time engaging them and getting them motivated to be productive, enthusiastic, and creative on the job.

You created this not by an error of commission. You didn't do anything to do it. You didn't do something to make the balance in the first place. So how do you correct this state of affairs? You must carve out regular time in your schedule to round and shadow your people and have positive or neutral interactions with you. By the way, as I've taught before, when you put your leader hat on and go out to round or shadow, make sure that you exchange giving orders for asking questions and look for opportunities to say thank you specifically. Thanks for your hard work. We really appreciate it. And then give them a specific reason why you're thanking them.

You can actually do a quick test right now to see what your trust balance is. Go ahead and show up on one of your direct reports' ward or wing or service, at a time when you're not expected, and put yourself in a hidden situation where, when you stand up and they see you for the very first time, the instant they see you, where do their eyes go and what might they mutter under their voice? The two extremes of this are, if somebody sees you and says, "Well, Dike,"—that's my name, by the way—"Well, Dike, what are you doing here?" to "What do we owe this unexpected pleasure?" And the other extreme is they look down at their toes, sag their shoulders and say, "Oh, shit. What did I do now?" And I can tell you for a fact that 85% of leaders get the second of those two options. Don't let that be you. But if you ever want to test, that's all you got to do. I call that the "lookup trust test."

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Types of Trust in Leadership

Now, what kind of trust are we talking about? Just like currency has different denominations, trust has different denominations too. What might people trust?

1. I trust that my leader is open, truthful, honest, and transparent, and what he or she tells me is the truth, the whole truth, and nothing but the truth. Most people fail that every day because there's incompletions and fudge factors and other things that we do to influence the way the workers perform and yet are not the whole truth.

2. How about this? I trust that someone cares about me as a person at work.

3. Or this: I trust that I will have all the materials I need to do my job right.

4. And this one: I trust that if I speak up and give my input in a team meeting, it will be honored, valued, and used to improve the performance of the team.

Trust is so important to team performance that there's actually a book called The Speed of Trust. Now that might not make sense on first reading—The Speed of Trust—but think about it. Think back in your career on teams that rocked and rolled and really performed—the teams you enjoyed the most and got the most done. What was the level of trust between the members of that team? And think about the teams you've worked on in the past that failed to launch or just completely blew up and dissolved and fell apart. What was the level of trust between the members of that team? Yeah, right.

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Building Trust Takes Time, Losing Trust Happens Instantly

So now think about The Matrix movies. Remember the end of the first Matrix movie when Neo finally could see the numbers streaming down the walls? Well, right now, you've got the key to the matrix of relationships and leadership skill and effectiveness at work. It's trust. Trust is the letters and numbers streaming down the walls inside the matrix of your workplace, and every interaction is a chance to make a deposit or a withdrawal.

And before I go, just one last thing: Do you build trust fast or slow? Yeah, slow, right? It takes multiple touches to have a positive trust account between you and your people. Do you lose trust fast or slow? You can lose trust in a heartbeat.

So as you scan your conversations, your meetings, your appointments, your interactions with your people over the course of the day ahead, notice trust is at play in every one of those relationships. Rehearse what you're going to say. Be empathetic to your people's concerns and work stresses so that you're making deposits in your trust account and not blundering through the day, blowing the balance on awkwardly stated and incompletely thought-out priorities and conversations.

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Conclusion: Trust as the Fundamental Currency

The fundamental currency is trust. It's in play at all times, just like the numbers in The Matrix. Put your trust glasses on. See it everywhere. Manage it actively.

That's it for today. Until we're in the next podcast, you keep breathing. Have a great rest of your day.