The 10 attributes of trustworthy people

"Few professions enjoy the public confidence that veterinarians experience."

This statement appeared in Veterinary Economics in 1997 (volume 38; page 40) is supported by the authors of the 1999 KPMG-LLP study of the veterinary profession, which stated in part that, "Veterinarians rate very favorably in public opinion among their clientele relative to other occupations (physician, accountant, chiropractor, lawyer, dentist, teacher and pharmacist)" (JAVMA 215; 161-183, 1999).

Pet owners rank veterinarians first in compassion, honesty, and trustworthiness, second in intelligence, and third in level of education and technical proficiency. Horse owners rank veterinarians first among all these professional organizations with respect to intelligence, level of education (tied with physicians), compassion, honesty, trustworthiness and technical proficiency.

Losing confidence?

However, there is recent evidence that some individuals may be losing confidence in those of us who practice veterinary medicine.

For example, in April of 2002, DVM Newsmagazine (volume 14, page 6) published a letter written by a pet owner concerned about the cost of veterinary care stating in part, "I once trusted veterinarians. I don't now." In response to an article in the July 2003 issue of Consumer Reports entitled, "Veterinary Care Without the Bite," the July 2003 issue of DVM Newsmagazine (volume 34, page 45 contained the following statement: "If veterinarians are preoccupied with the almighty dollar, it would appear that the trust clients hold for veterinarians would be jeopardized."

In this regard, we may be facing the same dilemma already encountered in a greater magnitude by physicians. According to one authority, "Medicine has long been one of our most trusted social institutions. In recent years, all social institutions, including medicine, have fallen from public trust." (J Oklahoma State Med Assoc 94: 46-54, 2001). Another author stated, "The commercialization of medical care, conflicts of interest, media attention to medical uncertainty and error, and the growth of managed care all challenge trust." (Milbank Q 74: 171-189, 1996).

A matter of trust

These statements prompted me to reflect on the meaning of the word "trust," and also to reflect on what should be considered to gain and sustain our clients' trust. (This essay was adapted from commentaries that were published in JAVMA 203; 1390-1391, 1993, and JAVMA 221: 936-938, 2002).

How would you define the word "trust?" Webster's dictionary defines trust as confidence in the honesty, integrity, reliability and justice of another person. Trust is one of the highest forms of human motivation.

Trust, or lack of it, is the root of success or failure in relationships with clients, colleagues, employees, employers and organizations, such as pharmaceutical firms and veterinary medical associations. In a climate of trust, veterinarians and clients can work cooperatively to establish shared objectives of patient care and to seek reasonable ways of achieving them.

Ironically, it usually requires many positive actions for us to earn and maintain our clients' trust, yet their confidence in us can be undermined if they perceive that even one of our actions is uncaring or self-serving.

Ethics remain important

How can we build and sustain trust in our relationships with others? Of course, the answer is by being trustworthy. We can't have trust without being trustworthy.

Trustworthiness in turn is based on ethical principles including the principle of character (what we are as persons), and the principle of competence (what we are able to do as persons). For example, if you have faith in my character as a person, but not in my competence as a veterinarian, you may trust me as a friend, but you may not trust me to provide you with needed veterinary services. Alternatively, you might trust my intellectual and technical competence as a veterinarian but lack confidence in my character.

Most of us have devoted a great deal of time, energy and money in acquiring and maintaining a high degree of competence to practice veterinary medicine. But, what about our ethical character? How can each of us build and maintain this aspect of or trustworthiness?

Please consider the following 10 principles.

• 1. Because trust is based on truth, trustworthy people must be truthful.

Trustworthy people know that it's not enough to possess a truth; the truth must possess them. What is a common result when we learn that someone has lied to us? Whatever he or she says after that may be suspected of being false, however true it may be. Likewise, lies defended as white cannot always be easily dismissed. What we perceive as harmless or even beneficial may not be so in the eyes of the deceived.

• 2. Trustworthy people are honest.

They match their words and feelings with their thoughts and actions. They do not think one thing and speak another. When we bad mouth people behind their back and sweet-talk them to their face, we undermine trust. Trustworthy people do not take what belongs to others, whether it is ideas, statements, credit or possessions, without their permission. They share successes by giving credit where credit is due. In addition to being honest themselves, trustworthy people strive to keep their associates honest by communication and constructive dialogue.

• 3. Trustworthy people are reliable; they keep their promises.

Their "yes" means yes, and their "no" means no. They honor their commitments. This includes keeping appointments, whether they are with clients, colleagues, sales personnel or family members. Few things inspire trust in another sooner than punctuality. You might as well steal another's money as their time.

• 4. Trustworthy people are loyal.

They try to be especially loyal to those who are not present. By defending those who are absent, we retain and build the trust of those who are present. Trustworthy people know that to repeat unkind gossip about others is a divisive way of praising one's self. Therefore, they are careful not to repeat gossip, unless they have a sound basis for considering it to be true and beneficial.

• 5. Trustworthy people are not biased or prejudiced.

They strive to attribute good motives to the actions of other people. We are all prone to being too quick to censure others, when we will not endure advice ourselves. Being quick to question the motives of others is not a sign of trust. We usually give ourselves credit for having good motives for what we say and do. Shouldn't we do the same for others?

• 6. Trustworthy people are humble, recognizing that the truth may not always be with them.

They interact with others on the assumption that they do not have all the answers and all the insights. They don't have a superior attitude. They value the viewpoints, judgments and experiences of others. Therefore, trustworthy people try to understand others' viewpoints, while maintaining their own commitment to proper values and principles. Having the inner strength to be humble, especially during times of provocation, is often the difference between those who command, and those who demand respect. Likewise, having a humble demeanor protects a counselor from making damaging remarks and errors, and thereby makes advice easier to accept.

• 7. Trustworthy people are accountable.

They try to recognize, admit and accept responsibility for their own mistakes. If they say things they didn't intend to say, especially under times of stress, they are quick to apologize. They recognize that anger often gets them into trouble, but it is pride that keeps them there.

• 8.Trustworthy people are cooperative.

They abide by the rules and policies of the organization. At the same time, they do not invalidate the spirit of the law by demanding the letter of the law. They know that just because they have the right to do it, doesn't mean it's right to do it.

• 9. Trustworthy people are just.

They are just not only to those who are just with them, but also with those who endeavor to injure them. Trustworthy people strive to return kindness for offense and patience for impatience. They would rather suffer wrong than do wrong! They recognize that the best defense against misrepresentation is fine conduct.

• 10. Trustworthy people promote communication and understanding.

They know that open and honest communication is built on the cement of trust.

We can communicate with others we trust, almost without words. We even can make mistakes in our verbal communication, and still find that they understand our true meaning.

When the level of trust is low, however, others may not believe even our most eloquent words. To foster trust, trustworthy people strive to share ideas and rationale for their positions and desires, while maintaining genuine respect for others' ideas and perspectives. Why? Because they have learned that when trust is low, communication is exhausting, time-consuming and often ineffective.

In summary, trustworthy people know that trust is gained more by conduct than just thoughts and words. Their daily conduct provides evidence of their intent to be honest, reliable, loyal, unbiased, humble, accountable, cooperative, just and communicative. However, if trustworthiness is to grow, still more is required. Our conduct must be motivated by trusting others, in addition to our desire to be trusted by them. Trust is a two-way street. To reach its greatest potential, it must allow interaction in two directions.

If we begin our relationships with individuals, organizations, or businesses with a lack of trust, then our relationships with them may not grow. Why? Without trust, there isn't a foundation to build permanent cooperation and collaboration. Likewise, if misunderstandings develop, there is little hope that distrusting individuals will work together to resolve their differences. Instead of talking directly with each other in this situation, it is common to tell our version of misunderstandings to others in order to justify our position. What is the antidote for a tendency not to trust others? The antidote is unselfishness. Our trust in others is a form of generosity. To paraphrase the golden rule, shouldn't we strive to trust others, as we would have them trust us?

By Carl A. Osborne

DVM, Ph.D., Dipl. ACVIM

Dr. Osborne, a diplomate of the American College of Veterinary Internal Medicine, is professor of medicine in the Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Minnesota.