I've been in rooms where trust was the only thing standing between an organization and collapse. Congressional hearings where the stakes were measured in patient lives. OIG investigations where every decision was scrutinized. Media cycles that could have destroyed institutions if the people inside them hadn't believed in the leader navigating the storm.
In those moments, strategy is insufficient. Authority is insufficient. The only thing that holds — the only thing that keeps an organization moving forward when everything outside is trying to tear it apart — is trust.
"There is one thing that is common to every individual, relationship, team, family, organization, nation, economy, and civilization throughout the world — one thing which, if removed, will destroy the most powerful government, the most successful business, the most thriving economy, the most influential leadership. That one thing is trust."
Stephen M.R. Covey — The Speed of Trust (2006)
I've built my entire career on that conviction. And I've seen it validated in every organization I've led.
Trust Is Not Given. It Is Built.
When I walked into my new healthcare system as CEO, trust was at a low point. The workforce had been through leadership transitions. Promises had been made and broken. Staff had learned that the safest thing to do was keep their heads down and wait for the next leader to come and go. Why invest in someone who won't invest in you? I've seen this same dynamic in private-sector hospitals, in military units, and in corporate organizations. The industry is different. The trust deficit is identical.
I understood that dynamic. I'd seen it before. And I knew that no speech, no memo, no town hall was going to change it. Trust isn't declared. It's demonstrated — through behavior, over time, under pressure.
"Trust is the lubrication that makes it possible for organizations to work."
Warren Bennis — Leaders: Strategies for Taking Charge (co-authored with Burt Nanus, 2003)
But what most leaders miss is the mechanism. How does trust actually form? Not through grand gestures. Through small, consistent acts of integrity that compound over time.
My approach is deceptively simple. I tell people exactly what I'm going to do. Then I do it. Then I come back and show them I did it. Every time. Without exception. When I can't do something, I say why. When I make a mistake, I own it publicly. This isn't a leadership technique. It's a leadership discipline.
The Three Dimensions of Trust
Frances Frei, the UPS Foundation Professor at Harvard Business School, developed a framework for trust that resonates deeply with my experience. In her work published in the Harvard Business Review, she identified three drivers of trust: authenticity, logic, and empathy. When trust breaks down, she argues, it's because one of these three drivers has become "wobbly" — her term for the element most likely to fail under pressure.
I think about this framework in operational terms:
The workforce sees the real you — not a polished executive persona, but a leader who is the same in the hallway as in the boardroom. In my 20 years in the Navy, I learned that the people closest to the mission can detect inauthenticity faster than any board of directors. When I walk the floors of my hospital and sit with frontline staff, I'm not performing accessibility. I'm being who I am. The workforce knows the difference — whether it's a military formation, a hospital ward, or a corporate floor.
Your decisions make sense and your competence is evident. I've managed a pathology crisis involving 19,794 patient lookbacks across multiple states under congressional and OIG scrutiny. In that environment, every decision had to be defensible — not just emotionally, but analytically. The playbook I built was so operationally sound that Congress eventually codified it into law. That's logic at scale. People trust leaders who demonstrate that they know what they're doing.
Your people believe you genuinely care about their wellbeing, not just their output. This is where many hard-charging executives fail. They earn trust on logic and authenticity but lose it on empathy — treating people as resources rather than human beings. When I took a 3,000-person organization from last-quintile to first-quintile in workforce retention nationally, it wasn't because I was a better strategist than my predecessors. It was because the workforce believed I cared about them. And I did. That belief changes everything — in any organization, in any industry.
Trust Under Scrutiny
In low-stakes environments, trust is nice to have. In high-stakes environments — the kind I've operated in for most of my career — trust is survival.
During the pathology crisis, I was managing an organization under simultaneous congressional oversight, OIG investigation, and national media coverage. Every decision was public. Every mistake would be amplified. In that environment, the instinct is to control information, manage perception, and protect yourself. I went the other direction. I shared everything I could, as transparently as I could, with both the workforce and the oversight bodies.
"While high trust won't necessarily rescue a poor strategy, low trust will almost always derail a good one."
Stephen M.R. Covey — The Speed of Trust (2006)
In the pathology crisis, our strategy was sound. But it would have collapsed without trust — trust from the staff doing the lookback work, trust from the patients and families affected, trust from Congress and the OIG that we were handling it correctly. Trust was the infrastructure that held the operation together.
I saw the same principle operate in a completely different context at Lovell Federal Health Care Center, where I led the personnel integration of 3,000 employees across two cabinet-level departments into the nation's first joint federal healthcare entity. I designed the organizational structure, wrote the concept of operations, stood up six directorates, and helped craft the legislative language that was codified into the 2010 National Defense Authorization Act and signed by the President into law. But none of that would have happened without trust. The Navy civilians didn't trust that their pay and status would be preserved. The other workforce didn't trust that their bargaining rights wouldn't be overridden. I had to build trust in both directions simultaneously — through transparency about what was changing, honesty about what I didn't yet know, and follow-through on every commitment I made to both sides. I negotiated with Senate and House Armed Services staff, department leadership, labor partners, veteran service organizations, and community stakeholders. We mapped 533 Navy civilians into new roles without a single loss of pay or status. That outcome was built on trust, not authority.
Patrick Lencioni, in The Five Dysfunctions of a Team, identifies the absence of trust as the foundational dysfunction from which all others flow. He distinguishes between "predictive trust" — confidence that someone will behave consistently — and "vulnerability-based trust," which he defines as the willingness to say "I don't know the answer," "I need help," or "I was wrong." Lencioni argues that this deeper form of trust is the prerequisite for real teamwork, and that "the only way we can achieve vulnerability-based trust on a team is if the leader goes first."
That resonates with my experience. In every organization I've led, I've modeled vulnerability before I've asked for it. I've admitted what I didn't know. I've acknowledged where I needed help. And I've owned my failures publicly — not as a performance, but as a standard. When the CEO does that, it gives permission to the entire organization to do the same. And when people stop hiding their mistakes, you can actually fix the problems that matter.
Trust as an Operating System
In my C3PT framework — Communication, Collaboration, Culture, Perseverance, and Trust — Trust is the fifth pillar, but it's also the foundation beneath all of them. You can't communicate effectively in a low-trust environment because people won't believe what you say. You can't collaborate across silos if departments don't trust each other. You can't build a healthy culture on a foundation of suspicion. And you can't persevere through adversity if the people around you don't trust that the sacrifice is worth it.
Amy Edmondson's research on psychological safety reinforces this at the team level. Her foundational study demonstrated that "team psychological safety" — a shared belief that the team is safe for interpersonal risk-taking — directly predicts learning behavior and, through it, team performance (Administrative Science Quarterly, 1999). In the organizations I've led, I've seen this play out repeatedly: teams that trust each other learn faster, adapt faster, and perform at levels that low-trust teams cannot reach regardless of individual talent.
This is why I treat trust as an operating system, not a value statement. It's not enough to say "we value trust" and put it on a wall. Trust has to be built into how decisions are made, how information flows, how mistakes are handled, and how people are treated every single day. It's an infrastructure — and like all infrastructure, it requires daily maintenance.
How I Build Trust: The Practitioner's Method
After 25 years of leading organizations through crisis and transformation, I've distilled my approach to trust-building into principles I apply in every engagement:
Show up before you speak up. In the first 30 days, I listen more than I talk. I walk every floor of every building. I ask questions. I learn names. By the time I address the organization publicly, they've already seen me in the hallways. The speech confirms what the behavior already demonstrated. This works the same whether the hallway is in a hospital, a military installation, or a corporate headquarters.
Keep your commitments — especially the small ones. Covey wrote: "One of the fastest ways to restore trust is to make and keep commitments — even very small commitments — to ourselves and to others" (The Speed of Trust, 2006). I've found this to be absolutely true. If I tell a department I'll follow up by Friday, I follow up by Friday. Every time. The small commitments build the credibility for the large ones.
Be consistent under pressure. Anyone can be trustworthy when things are calm. The test of trust is behavior under stress. During the pathology crisis, my team watched how I responded to pressure from Congress, from the media, from the OIG. I responded the same way every time: with facts, with transparency, and with accountability. That consistency under fire built more trust than any leadership retreat ever could.
Make accountability reciprocal. Trust isn't a one-way street. I hold my team accountable, and I hold myself accountable to them. When I make a mistake, I name it. When I change direction, I explain why. This reciprocity creates what Lencioni calls vulnerability-based trust — and it transforms the relationship between leader and organization from compliance to commitment.
The Bottom Line
I've led the first-of-its-kind integration of two cabinet-level departments that required building trust across 3,000 employees, Congress, and multiple stakeholder groups — work that became federal law. I've managed the most significant patient safety crisis in national healthcare history under congressional, OIG, and media scrutiny. I've taken broken organizations in the private sector and rebuilt them into nationally recognized performers. And in every single case — regardless of the industry — the turning point wasn't a strategy document or a reorganization chart. It was the moment the workforce decided to trust the leader.
You can't buy trust. You can't mandate it. You can't shortcut it. You can only earn it — through behavior, through consistency, through vulnerability, and through time. And once you earn it, you have to protect it every single day, because trust is the most fragile and most valuable asset any leader possesses.
That's not theory. That's 25 years of walking into rooms where trust had been destroyed and rebuilding it from the ground up. It's the hardest work in leadership. And it's the only work that matters.
Trust Starts with a Conversation.
If trust has eroded in your organization and you need a leader who knows how to rebuild it, let's talk.
Start the Conversation