JOHN TOBIN VERSION HISTORY

Date Version Description Name

28-10-2016 0-1 John Tobin Naked Trust 102516 Final BM TC (1) (1)457 v4 BM

Bob

07-11-2016 0-2 First format David

21-11-2016 0-3 Enhanced author image David

e-ORGANISATIONS & PEOPLE, WINTER 2016, VOL. 23, NO. 4 PAGE 1 WWW.AMED.ORG.UK

BACK TO CONTENTS

Naked Trust Understanding trust as simple predictability in local interaction

John H. TobinIn this article, I argue that trust, as usually deployed in organisations, is

what Mead (1923) calls a cult value. This is an idealisation - rarely

achieved in reality—which can be paradoxically inspirational/aspirational

and destructive at the same time. When creating a culture of trust

becomes a management project, it becomes an instrument of power, with

the negative effects of stifling reflexivity, compelling conformity of

behaviour, etc. As professional organisations (e.g. Mintzberg 1989), in

which communities of practice are prevalent, hospitals are especially

resistant to top-down trust building programmes. In contrast to the

business literature on how to build an organisation-wide culture of trust, I

suggest that genuine trusting relationships develop spontaneously in

smaller groupings, both formal and ad hoc, which are characterised by interdependency, common interest

and stability over time. This has implications for how we understand and foster trust in organisational life.

Keywords: trust, cult value, functional stupidity, communities of practice, predictability, professional organisation

IntroductionWhen I retired after some 35 years as a hospital executive in the US, I planned to use the extra time that

retirement affords to do some reading, research, reflection and writing. I have always been interested in the

realities of management practice, and I have learned to rely on common sense and the practical wisdom

one gains through lived experience. A retiree’s freedom from the everyday politics of organisational life also

affords an opportunity to reflect on one’s experience from a more detached perspective, and therefore,

perhaps, with a bit more honesty and objectivity than is possible for one still so enmeshed. Over the years,

I’ve also “discovered” writers and thinkers outside of the standard business literature genre who think about

management issues and concerns in novel ways that resonate with my own experience. These people offer

much more to the thoughtful executive than the avalanche of often faddish advice of most orthodox

management theorists, consultants and other experts.

I hope to illustrate in this article how these ideas and reflections led me to a different way of thinking about

the concept of trust in organisational life.

e-ORGANISATIONS & PEOPLE, WINTER 2016, VOL. 23, NO. 4 PAGE 2 WWW.AMED.ORG.UK

BACK TO CONTENTS

Trust definedCreating a “culture of trust” seems to be among the hot topics currently making the consulting rounds. A

Google search of “trust in organisations” will turn up scores of articles whose authors define trust in terms of

certain positive values and traits--loyalty, caring, fairness, integrity, competence, consistency—and assign

leaders the role of creating a culture of trust within their organisations through behaviours that enact those

traits, such as ethical personal behaviour, open communication, social responsibility, sensitivity to employee

needs, and the like. They claim that trust, and a culture of trust so defined, is essential to corporate results

and performance, because it enables collaboration and fosters employee loyalty and commitment. A good

example: http://rube.asq.org/hdl/2010/06/a-primer-on-organizational-trust.pdf.

After introducing a bit of theory, I briefly explore why cultural context, the phenomenon of “stupidity

management”, and the peculiarities of the professional organisation render trust an elusive goal in many

modern organisations.

Trust: culture…or cult?

According to early 20th Century philosopher and social

psychologist George Herbert Mead (e.g. 1908; 1923),

ethical problems arise in society when the competing

values and needs of individuals come into conflict.

Historically, such problems were simply referred back to

the authority and rules of some powerful institution like the

Church. Mead believed that the more complex ethical

dilemmas of the modern world (and, indeed, modern social

problems in general), could not be reduced to compliance

versus non-compliance with fixed principles. Rather, they

could and should be resolved through application of the

same methodological principles that were at that time

having such spectacular successes in the natural sciences.

All factors and competing interests in play must be

subjected to rational analysis in order to formulate a course

of action satisfactory to all the actors. (Joas, 1985)

Mead (1923) acknowledged that there were barriers to such an enterprise in the social realm that ideally

should have no correlates in the natural sciences. Mead called these “cult values”—social controls in the

form of idealised values that develop within societies and are embodied in that society’s institutions. Cult

values are an important part of our social heritage and fundamental to societal cohesion. They can be both

inspirational and aspirational in that they hold out to members of a society that which is desirable, possible

and worth striving for, but rarely, if ever, fully realised. “Liberal Democracy” is such a cult value in the West,

a persistent ideal despite the manifest shortcomings of our actual governing institutions and processes.

e-ORGANISATIONS & PEOPLE, WINTER 2016, VOL. 23, NO. 4 PAGE 3 WWW.AMED.ORG.UK

BACK TO CONTENTS

Cult values are destructive and polarising when adherence suppresses rational assessment of the cult itself.

Opposing cult values and the ideologies they spawn, such as climate change, the Second Amendment to the

US Constitution, national border integrity, for example, are held by people at the opposite ends of the political

spectrum in the US with such tenacity that common-sense compromises based on facts and analysis are

impossible to achieve. When such cult values are espoused by a governing elite, they enable the powerful

to impose conformity on the rest of the group. Border security, for example, is contentious around the world:

http://www.businessinsider.com/donald-trump-border-wall-global-immigration-security-2016-9.

Cult values are not limited to whole societies, but can be found in any group or faction within that society—

including large corporations. Trust, as that concept is usually deployed in organisations, is just such a cult

value. When creating a culture of trust becomes a management project, it can become an instrument of

power that stifles reflexivity, compels conformity of behaviour, etc.

And, a bit more theory…

Stupidity management and the cult of trust

(Source of image: DILBERT © 2011 Scott Adams. Used By permission of UNIVERSAL UCLICK. All rights reserved).

A few years ago, in response to this marked increase of articles in the business literature concerning trust,

Stacey (2012) wrote a thoughtful article on trust, as it is treated in both the popular business and the

scholarly literature, for his Complexity and Management Centre blog

(https://complexityandmanagement.wordpress.com/2012/11/23/trust-in-organisations/).

Stacey thoroughly researched ways in which the concept is defined by thinkers in various disciplines.

However, practising managers are not likely to think so deeply about trust or consult the scholarly literature.

For most of us, a good dictionary definition is more than enough: “Firm reliance on the integrity, character or

ability of a person or thing” or “Belief that someone or something is honest, good, reliable, effective, etc.” As

Stacey notes, management consultants also tend to define trust in this way.

Stacey then introduced his readers to a provocative article, “A Stupidity Based Theory of Organization”, by

Mats Alvesson and Andre Spicer (2012), in which the authors introduce the concepts of “functional stupidity”

and “stupidity management”, and which they further develop and expand upon in their new book, “The

Stupidity Paradox: The Power and Pitfalls of Functional Stupidity at Work” (Alvesson & Spicer 2016).

e-ORGANISATIONS & PEOPLE, WINTER 2016, VOL. 23, NO. 4 PAGE 4 WWW.AMED.ORG.UK

BACK TO CONTENTS

According to Alvesson and Spicer,

‘…functional stupidity is inability and/or unwillingness to use cognitive and reflective capacities in

anything other than narrow and circumspect ways. It involves a lack of reflexivity, a disinclination

to require or provide justification, and avoidance of substantive reasoning’. (2016, p 239)

Rhetoric versus realityStacey argues that the rhetoric of trust-building behaviours includes involving employees in decision making,

encouraging employees to demand and expect justification for decisions and policies, establishing self-

managing teams, and the like. But such “empowerment” behaviours threaten executives’ status and raison

d’être, and shift unwanted responsibilities to employees.

To avoid the resulting stress and uncertainty, leaders resort to behaviours that have the effect of suppressing

reflexivity, encouraging conformity, and deflecting challenges to management diktats. Examples include

setting agendas, promoting a cult of leadership (the boss knows best), promoting company ideologies (action

orientation, optimism), limiting criticism by defining when and how criticism is allowed (only criticise if you

have a solution to offer) and so forth. These are exactly the strategies that encourage functional stupidity.

Since many employees do not want the responsibility and accountability that accompanies empowerment,

they collude with management through actions and attitudes that Alvesson and Spicer call “stupidity self-

management”.

Cult succumbs to stupidityStacey was struck by the similarity between the rhetoric of trust building as it appears in both the scholarly,

but more particularly, in the mainstream business literature, and the reality of management behaviours that

Alvesson and Spicer describe and document. Linking this with Mead’s notion of cult value allows me to

suggest a plausible explanation for the fact that organisation-wide trust is rarely achieved in practice. The

strategies prescribed by experts to achieve “a culture of trust” are simply too threatening to management

power, status and legitimacy, whilst imposing unwelcome responsibility and accountability on workers. Both

employ the strategies of functional stupidity to undermine the trust-building project.

Trust and mistrust emerge in social processesWhat actually happens, Stacey argues, is that the dynamics of trust and mistrust in organisations emerge in

interactions among individuals and small groups at the local level. Individuals develop attitudes of trust or

mistrust toward other individuals or groups through lived experience in social interaction. Individuals coming

into an organisational setting are predisposed toward certain attitudes by their own social history. Attitudes

concerning trust and mistrust can be shaded and nuanced, rather than manifest as an either/or dichotomy,

and will evolve over time. In Stacey’s view, it is the emergent social structure itself and the institutions of our

disciplinary society that constrain behaviour in ways that enable collaboration and cooperation without having

to fall back on some illusory culture of trust at all.

With this as background, let us now look at the ways in which trust actually does emerge in the professional

organisation, one type of which is the hospital.

e-ORGANISATIONS & PEOPLE, WINTER 2016, VOL. 23, NO. 4 PAGE 5 WWW.AMED.ORG.UK

BACK TO CONTENTS

The emergence of trust in communities of practiceTechnician as archetypeIn an article directly relevant to hospital organisations, Barley (1996) and his colleagues did an extensive

ethnographic study of technical work. Barley argues that the nature of work in modern, post-industrial

organisations has become increasingly technical in nature. The technician has emerged as an archetype of

the modern, post-industrial worker, while organisational and management theory, and the organisational

forms and management techniques that result, remain rooted in an image of work that obtained in the

industrial economy of the mid-20th century. To bring management and organisational theory into sync with

the nature of the modern workforce, Barley proposes the technician as a useful standard type upon which to

base further study and analysis.

Barley describes technicians as intermediaries between the real world and the world of signs and symbols. In

health care, technicians use technologies to abstract flesh and blood human beings into images and data.

These abstractions are then interpreted by medical professionals, who design therapies—still in the

abstracted form of drug dosages, radiation beams, electrical stimulation—that technicians, using their

machines and instruments, apply to flesh and blood humans to ameliorate their ailments. In a hospital, there

are many explicitly technical disciplines—laboratory technology, radiologic technology, for example--and

other disciplines, such as nursing and medicine, that have a significant technical component to their

practices.

‘Trust building’ as an entirely local processWhat is relevant here is the social construction of technical work and its bearing on the notion of hospital

leaders creating an organisation-wide culture of trust. Technicians tend to form highly localised, idiosyncratic

communities of practice whose members learn from each other, share information and workplace habits, and

work in a highly

interdependent relationship

with related professionals

(medical technologists with

pathologists, for example).

As Illustration 1 here

illustrates, members of

communities of practice work

in close physical proximity

with each other, share

common interests and speak

a common language--the

nomenclature and jargon of

their specialty (Etienne &

Beverley Wenger-Traynor

2015).

Illustration 1: Knowledge creation within a community of practice

(Source: Allan, B. (Designer). (2008). Knowledge creation within a community of practice. [Web]. Downloaded from https://convcme.wordpress.com/2011/02/04/communities-of-practice-a-framework-for-learning-and-

e-ORGANISATIONS & PEOPLE, WINTER 2016, VOL. 23, NO. 4 PAGE 6 WWW.AMED.ORG.UK

BACK TO CONTENTS

improvement/#comments )

Managerialising the hospital Although trends in hospitals today favour (or, perhaps, are forcing) integration of managerial and clinical

functions, the typical US community hospital has, for the most part, retained the organisational structure that

it has had for decades. When I began my career some 35 years ago, there was a clear division of authority

and responsibility between the managerial and clinical aspects of hospital governance. The executive and

board functions were responsible for managing the business of the hospital, such as billing and collections,

facilities maintenance, fundraising, and the like. Managing the care of patients was the responsibility of a

medical staff composed almost entirely of physicians in private practice. Nursing management was

accountable to and subordinate to both managerial and clinical strands of governance. They were

responsible to management for budgets, staffing levels and the like, and to physicians for actual patient care.

To the extent that administrative management was involved in clinical matters, it was in an essentially

supportive role, in respect of, for example, regulatory compliance, resources, facilities, and equipment.

Illustration 2 below shows these two distinct, traditional strands of governance.

Illustration 2: A simplified (US) Hospital Organisation Chart, 1970s

The growing predominance of the business paradigm in US hospital managementAs one would expect, the professional educational preparation for hospital executives was geared toward

this business management role. Now, however, driven by the increasing domination of the health care

industry by government bureaucracies, changes in tort law, the growing extent to which medical care is

provided by doctors directly employed by the hospital, and other factors, the hospital corporation as a legal

entity has become increasingly accountable for managing the clinical work, too. That, in turn, has resulted in

a gradual growth in the power and status of managerial function at the expense of the professional/technical

function. Despite this change, however, the education of hospital executives remains firmly rooted in the

business paradigm. For those of us who lived through this transition, it was possible to partially compensate

for this educational deficit by bringing physicians into the senior management team, by elevating the status of

nursing within the management hierarchy, and by picking up a certain amount of clinical knowledge

e-ORGANISATIONS & PEOPLE, WINTER 2016, VOL. 23, NO. 4 PAGE 8 WWW.AMED.ORG.UK

BACK TO CONTENTS

through personal effort and osmosis. But as the technology of medicine becomes more complex and

pervasive, managerially trained executives cannot function effectively in both worlds. Hospitals and other

professional organisations have become increasingly “managerialised”. Consequently,

professional/technical work is increasingly subordinated to management control and tensions (or outright

subversion) inevitably arise between the two groups. (Scott, 1990)

The culture clash in managerialised professional organisationsOne would anticipate that members of a close-knit community of practice, with its insider/outsider dynamics,

would be non-receptive – if not outright hostile -- to so called best practices and other prescriptions imposed

by outsiders to the community of practice, especially if those outsiders are perceived to be ignorant of the

nature of the work being performed. And in the typical hospital, senior management is just such an outsider:

“An increasingly horizontal distribution of expertise not only undermines hierarchy as a coordinating

mechanism, it undercuts management’s source of legitimacy. When those in authority no longer comprehend

the work of their subordinates, hierarchical position alone is an insufficient justification for authority, especially in

technical matters. Under such conditions, leaders who insist otherwise, risk making decisions based on

incomplete information, faulty understandings, and criteria that sacrifice long-run effectiveness, which, even in

the absence of a turbulent macroeconomic environment, should almost guarantee that firms will perform

poorly.” (Barley, 1996, p. 438)

Generalising the hospital argumentModern business organisations and social institutions are characterised by increasingly granular division of

labour and specialised function, and thus by a high level of interdependence among the organisation’s

members. Any work beyond the simplest tasks can only be done through collaboration. All organisations

generate many groupings, many of which are random assemblages (as far as the participants are

concerned) formed by the structure of the organisation itself. Such groupings include departments, sections,

nursing units in hospitals, groups who work together in large offices, and so forth. There are also ad hoc

groups put together for some specific purpose, e.g. committees, task groups and the like.

The following table (Table 1) suggests characteristics of the formal and informal groupings that can be found

in a typical US community hospital. However, it is essential to emphasise the obvious: formal and informal

group dynamics are going on within and among members of all groups all the time, and groupings continually

evolve and change. Therein lies the complexity of organisational life and the emergent culture of each

organisation. Reality never fits into neat tables or grids.

Within and among these groupings are the technology based communities of practice I’ve described above.

In these smaller groupings, which tend to be relatively stable over time, the experience of day to day

interaction makes it possible to get to know, with a high degree of certainty, how one’s co-workers are likely

to behave in different circumstances. Interaction also helps to shape that behaviour, diminishing uncertainty

even further. No amount of exhortation from rather remote senior executives (especially in larger

organisations), no matter how eloquent they may be or how exemplary their personal behaviour might be,

can have an effect even remotely comparable to everyday, “up close and personal” interaction. In whichever

ways these local interactions play into the broader culture of an organisation, trust-building is an entirely local

process.

e-ORGANISATIONS & PEOPLE, WINTER 2016, VOL. 23, NO. 4 PAGE 9 WWW.AMED.ORG.UK

BACK TO CONTENTS

Table 1: Formal and informal groups in a typical US community hospitalFormal/Structural Formal/Special Purpose Informal

Example Divisions, Departments, Sections—the elements of a typical organisation chart

Committees, task groups, special purpose teams, regularly scheduled meetings (e.g., monthly Department Managers)

Highly variable: One-to-one friendships to communities of practice

Source of Authority/Legitimacy

Senior Leadership Senior Leadership Emerges within the group

Size Large: 25 to hundreds Smaller: 10 to 50, but may be larger or smaller

Small: 2 to whatever emerges within the group

Purpose Channels of authority and accountability as well as “official” communication

Completion of assigned tasks

Meet needs and interests of individuals involved. Usually a mix of social and work related activity.

Type of Communication

Some face to face conversation, but much written: reports, memoranda, email

Mostly face to face conversation, but some electronic. Work output mostly written: reports, minutes, presentations

Mostly face to face conversation, some electronic, rarely written.

Venue Within formal structure Within formal structure May emerge within formal structure, or emerge across organisational boundaries

Duration Years to life of the organization

Depends on function and whether convened for specific task or ongoing (e.g., standing committee). Weeks to years to life of the organisation

Highly variable and generally less stable. Some forms persistent while membership changes over time (e.g., communities of practice)

Content of Communication

Official, “public transcripts”

Task Oriented, but within official transcripts

Gossip, and “hidden transcripts”, but also trust building and knowledge formation and trans-mission (Scott, 1990, p14)

Structure Well defined by position, rules, policies

Well defined by position and skill set

Emergent, no specific structure

Group Leadership Defined by position. May involve “charisma” but rarely dynamic.

Defined by position, skills and experience. May be more dynamic, based on individual skills, experience and personal qualities.

Fluid and dynamic within the group, based on needs, personal traits, skills, experience and other factors

(Source: Tolbin 2016)

Within and among these groupings are the technology based communities of practice I’ve described above.

In these smaller groupings, which tend to be relatively stable over time, the experience of day to day

interaction makes it possible to get to know, with a high degree of certainty, how one’s co-workers are likely

to behave in different circumstances. Interaction also helps to shape that behaviour, diminishing uncertainty

even further. No amount of exhortation from rather remote senior executives (especially in larger

e-ORGANISATIONS & PEOPLE, WINTER 2016, VOL. 23, NO. 4 PAGE 11 WWW.AMED.ORG.UK

BACK TO CONTENTS

organisations), no matter how eloquent they may be or how exemplary their personal behaviour might be,

can have an effect even remotely comparable to everyday, “up close and personal” interaction. In whichever

ways these local interactions play into the broader culture of an organisation, trust-building is an entirely local

process.

My own experience has been that there is much more cohesion and camaraderie in these small groupings

than in the organisation as a whole. If asked why our hospital was a good place to work, our staff would

inevitably talk about their relationships with, and support from, their immediate co-workers.

There is a lot of how-to advice in the business literature on teamwork and trust building in teams, but I

believe that more genuine trusting relationships emerge spontaneously in these small groupings simply

because their members experience working together over an extended time.

Understanding trust as simple predictability in a local contextIf organisation-wide trust is an elusive goal, where does that leave managers who must facilitate

collaboration and engagement?

Most of the value-laden associations we have with the word trust are irrelevant for getting work done. Over

time, I have concluded that the essence of trust, at least the kind of trust that is necessary to get work done,

is nothing more than predictability. We learn through experience how to anticipate the likely actions of others

in given circumstances, and this reduces the uncertainty that can inhibit collaboration and cooperation. We

can trust, in the sense I am talking about here, devious and dishonourable colleagues, if their behaviour is

consistent over time.

It is also a simple reality in organisations—indeed, in social processes of any sort—that any one of us can

only sustain meaningful interaction with a limited number of other people at any given time. Relationships of

the kind that can foster genuine trust require time and effort to develop and sustain, and this only happens

through an on-going process of direct, interpersonal dialogue— i.e. simple, everyday conversation.

Within a work setting, our most important relationships will be with those who are most necessary to the

accomplishment of our own work, and we to theirs.

A Tale of One City (with Two Hospitals): the hypothesis as practice The small city in which I served as a hospital CEO is a typical New England factory town. The city has two

hospitals. Both organisations date from the late 19 th century; ours as a charity organisation founded by local

business leaders and industrialists, and the other a Catholic hospital established by the local Catholic

diocese to care for the mostly Catholic “working poor” immigrants who worked in the mills. The hospitals’

decades-long rivalry with each other was outwardly cordial, but privately mistrustful, not just at the executive

level, but also among boards of directors and respective medical staff members. The relationship had been

clouded by too many overtly competitive moves, too many misunderstandings, too much pride, too much

investment in local cultural, ethnic and economic class divisions.

As we moved into a post-industrial economy during the 1960s and 1970s, the community’s economy went

into a long decline. It became increasingly clear that the city could no longer sustain two hospitals, and both

hospitals became financially weaker. A prolonged work stoppage at our hospital showed that, if one hospital

was unable to function for any reason, the other couldn’t handle the patient load, and the entire community

e-ORGANISATIONS & PEOPLE, WINTER 2016, VOL. 23, NO. 4 PAGE 12 WWW.AMED.ORG.UK

BACK TO CONTENTS

suffered. A few leaders from each hospital’s board of trustees attempted to negotiate a merger of the two

hospitals to end what was seen increasingly as wasteful, destructive and ultimately pointless competition.

The merger project—the first of several—failed to overcome several obstacles, despite a good faith effort by

all involved.

Rather than give up on a merger altogether, the boards then charged the two CEOs with finding an

alternative means of moving the hospitals closer together and reducing competition. My counterpart and I

proposed a cancer treatment facility built around modern radiation therapy equipment. Neither hospital had

first rate cancer treatment equipment or facilities, and radiation therapy is primarily an outpatient modality.

Hence such a facility could meet a true health care need in our community, but could do so without changing

the hospitals’ relative competitive positions - the proverbial “win/win”. After some weeks of negotiation, in

which my counterpart and I participated directly (but no other executives from either hospital team did) the

hospitals reached an agreement. My own management team remained sceptical of our new partner’s

intentions, despite my reassurances. But, with the deal in hand, I went off on a long planned vacation with

my wife.

While we were away, my counterpart CEO made a comment that was quoted in the local newspaper. At this

point, I have no recollection of exactly what she said or how accurately she was quoted, but her comment

was interpreted by members of my management team as implying that our partner intended to renege on the

deal before it was formally consummated, and instead proceed to build a cancer centre on their own. I got

a frantic conference telephone call that evening with my senior team, who said, in essence, “See, we told

you…they are going to stab us in the back. You must come home immediately. We’ve purchased the plane

ticket, scheduled an emergency board meeting for tomorrow morning and a news conference tomorrow

afternoon. You have to announce that we are going to build a cancer centre on our own and beat them to

the punch.” I listened to this for a few minutes as all of this was sinking in, and I told them I thought their

reaction and proposed response were crazy. I instructed them to cancel the board meeting and press

conference, and told them I was absolutely not making an emergency trip back to CT. I said I would call my

counterpart in the morning to find out exactly what she said, to make sure she remained committed to the

deal we had made.

The following morning, I did have that conversation, and was reassured that the comment that precipitated

the mini-crisis was innocent and had been misinterpreted. We had a very nice conversation that served two

purposes. I was reassured that there was nothing amiss; but it also was a way to notify my counterpart of

the suspicions members of our leadership team and some of my board members held. Having given her

assurances to me directly, it would be very difficult to go back on that promise. I then called my board chair

and discussed the situation, and we agreed that everything was “on track” as it had been. My wife and I

enjoyed the rest of our holiday in peace.

The cancer centre project went forward. After raising $11 million for the project with a joint fund raising

campaign—another community first—we built a beautiful, modern facility that serves our community to this

day. The cancer centre was followed by another unsuccessful attempt at a full merger of the hospitals and

then by another joint project, this one to establish a joint open heart surgery program. Again, we achieved a

huge enhancement of the local health care system without giving one hospital or the other a competitive

edge.

e-ORGANISATIONS & PEOPLE, WINTER 2016, VOL. 23, NO. 4 PAGE 14 WWW.AMED.ORG.UK

BACK TO CONTENTS

All of this was possible without improving the underlying trust versus mistrust dynamics of the two competing

organisations. Gaining experience over time with the motives, biases and patterns of behaviour of the other

organisation’s leaders made it possible to develop an effective working relationship and to solve practical

problems.

Conclusion: the CEO’s role in trust building is important but limitedIn a professional organisation, such as a hospital, the CEO’s job is to make sure the work units are staffed by

competent people, that they have the necessary equipment and supplies, that they have means of

communication, that they have the resources needed to handle the unexpected, that they have a safe and

comfortable physical environment, and so forth. While that’s all important, senior management in a

professional organisation has very little to do with how work gets done “on the front lines.”

The CEO in any organisation serves an important symbolic role. It’s important for the CEO to “set the tone”

through example and to be considered by the workforce to be a person of competence, integrity and good

practical judgment. I certainly think of myself as a person of integrity, and always tried to act with openness

and honesty during my working years. But I also knew that I was just “the boss” to many of our staff, with all

the negatives that implies. I also believe that an ethical executive will act with integrity for its own sake, not

in pursuit of some corporate goal.

Many people enjoy working in a company with a charismatic, “rock star” CEO. But none of that matters much

in day to day work. High levels of work satisfaction, effective collaboration and “engagement” are all fine, but

it’s important to remember that the only people one needs to trust are most likely to be those standing next to

you.

Collaboration in organisations is built on interdependence, and on the means and ends of task

accomplishment. Of course, the most intimate relationships in our lives—family ties, close friendships, et

cetera--involve a great deal more than means and ends. But working relationships are primarily about

means and ends and other practical considerations. Understanding trust as simple predictability enables

collaboration, avoids clouding our business relationships with unnecessary and subjective baggage, and is

fundamentally more honest than preaching trust while practising stupidity management.

Suggested ReadingMead, G. H. George Herbert Mead never developed a complete system of ethics, and his ideas on ethics

are scattered among several essays and other writings. An excellent overview and analysis can be found in Joas, Hans (1997). G. H. Mead: A Contemporary Re-examination of His Thought, pp. 124-144, Cambridge, Massachusetts, The MIT Press.

Other relevant references for Mead:

Mead, G. H. (1908). “The Philosophical Basis of Ethics”, International Journal of Ethics, vol. 28, pp. 311-323

Mead, G. H. (1923). “The Scientific Method and the Moral Sciences”, International Journal of Ethics, Vol 33, pp. 229-147

Other sources

Alvesson, M. and Spicer, A. (2012), “A Stupidity-Based Theory of Organizations”. Journal of Management Studies, vol. 49, pp. 1194–1220. doi:10.1111/j.1467-6486.2012.01072.x

Alvesson, M. and Spicer, A. (2016). The Stupidity Paradox: The Power and Pitfalls of Functional Stupidity at Work, London, Profile Books Ltd. (Kindle Edition)

e-ORGANISATIONS & PEOPLE, WINTER 2016, VOL. 23, NO. 4 PAGE 16 WWW.AMED.ORG.UK

BACK TO CONTENTS

Barley, S. R. (1996). “Technicians in the Workplace: Ethnographic Evidence for Bringing Work into Organizational Studies”, Administrative Science Quarterly, vol. 41, no.3, pp. some 354-441. Available at: http://web.stanford.edu/group/WTO/cgi-bin/wp/wp-content/uploads/2014/pub_old/1996%20Technicians%20in%20the%20Workplace.pdf

Griffin, D. (2002). The Emergence of Leadership: Linking Self-Organisation and Ethics, London and New York, Routledge

Joas, H. (1997). G. H. Mead: A Contemporary Re-examination of His Thought, Cambridge, MA, MIT Press. (originally published in German, 1980)

Mintzberg, H. (1989), Mintzberg on Management: Inside Our Strange World of Organizations, New York, The Free Press, pp. 173-195.

Scott, J. C. (1990). Domination and the Arts of Resistance: Hidden Transcripts, New Haven and London, Yale University Press

Taylor, J. R & Van Every, E. J. (2014), When Organization Fails: Why Authority Matters, New York, Routledge (Kindle Edition). Although not cited directly in this article it was important background reading. Leaders of professional/knowledge organisations will find “When Organization Fails” valuable in understanding the problems and conflicts that arise when upper management does not fully understand the nature of the work being done by those who deal directly with the organisation’s customers.

Wenger-Trayner, E. & B. (2015). Introduction to communities of practice: a brief overview of the concept and its uses. http://wenger-trayner.com/introduction-to-communities-of-practice/. Accessed 15/10/16

About the authorJohn H. Tobin, DMan, MPH retired at the end of 2010 after a 35-year career in hospital management, 23 of

those years as CEO of Waterbury Hospital in Waterbury, Connecticut. He received a Doctor of Management

degree from the University of Hertfordshire in the UK in 2003, and a Master of Public Health from Yale

University in 1975. Throughout his career, he served on boards or committees of numerous professional

organisations as well as community service organisations concerned with social services, education,

philanthropy and economic development. John’s interests include the practical application of concepts from

the complexity sciences to everyday problems, particularly the ethics hospital quality and safety. You can

contact John at johntobin90@gmail.com

e-ORGANISATIONS & PEOPLE, WINTER 2016, VOL. 23, NO. 4 PAGE 18 WWW.AMED.ORG.UK

BACK TO CONTENTS