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Earning Loyalty and Trust Research Paper


Healthcare leadership, like any other leadership, is mandated to ensure that employees remain loyal to the organization they (employees) are working for. Loyalty of employees benefits an organization and helps to avoid unnecessary expenses such as training new employees by reducing the turnover rate. Leadership earns the loyalty of employees by first earning their trust.

The purpose of this research paper is to show how leadership in the healthcare sector can earn trust and loyalty from the employees. It will be emphasized that these two virtues can only be earned and not demanded. Earning trust and finally loyalty are depicted as processes which the leaders have to be committed to persistently.

In order to achieve the purpose of this research, secondary sources of information are utilized. Books and internet resources are used. Only those materials which focus on healthcare leadership are used. Personal insights are also added, especially in the discussion section.

The order of this research starts with an abstract, findings section, discussion, and a conclusion. There is also a list of the references used in the research paper.

Findings Section


Leadership in healthcare institutions presents various challenges. It has been noted that loyalties in these institutions are divided (Umiker, 2005). More often than not, workers are more loyal to workmates or unions than to their leaders. Specifically, it has been found that scientifically trained employees display more fidelity to their technical societies than to their leaders.

Middle level leadership has been said to be dilemmatic because of the split loyalty they need to show to their subordinates as well as to their superiors. Leaning too far to one side leads to airing of grievances and accusation of disloyalty by the other side (Umiker, 2005).

Loyalty is of great significance in the healthcare sector. Umiker (2005) argues that productivity is a primary casualty of absence of corporate loyalty which is then followed by “sloppy workmanship, apathetic employees, mediocre quality, and poor service” (p. 235). Umiker (2005) further notes that loyalty is lost when the morale of employees is destroyed and goes further to list the factors that destroy morale: “poor working conditions, poor compensation, and poor leadership skills” (Umiker, 2005, p. 235).

Therefore, loyalty is of great significance, but then how can it be fostered? Some of the actions that foster loyalty are as follows – “providing a safe work environment and reasonable opportunities for advancement, offering first-class benefits, rewards for high performance, and demonstrated respect for ability” (McConnell, 2010, p. 345).

Strengthening Loyalty

There are various measures that can be taken to strengthen loyalty. These measures also increase the level of trust between the leadership and the employees.

One of them is honesty. Leaders are advised to be honest with their employees (McConnell, 2010). Honest in this respect entails informing the employees about policies and plans that will and/or may affect them directly and/or indirectly. In this manner, trust is built between the leadership and employees and suspicion of ill motives by the employees on the leadership have no chance of developing.

Leadership should also ensure that what it expects the employees to accomplish is made clear to the employees and that they (employees) are empowered to do that. Leadership can do this by thoroughly carrying out “position descriptions, performance standards, orientation, and training” (McConnell, 2010, p. 345).

Other measures to building loyalty include consistency, fairness, impartiality, and trustworthiness. Leadership should significantly play a supportive role more than a judicial role. It should also be ensured that leadership values all the employees (McConnell, 2010). Gunderman (2009) airs similar sentiments concerning building loyalty.

He argues that physicians are not so much interested in giving their services to the highest bidders but rather are interested in working in organizations that “cultivate trust, foster pride in work, and encourage physicians to enjoy what they do” (Gunderman, 2009, p. 17).


According to McConnell (2010), loyalty and trust are inherently connected. Loyalty is a function of trust and trust must be earned. All the efforts that lead to earning of trust eventually have a final result of building loyalty. Trust has been singled out has being very beneficial to healthcare organizations.

According to Gunderman (2009), trust fosters high levels of collaboration. Lack of trust among employees lead to lowering of cooperation and raises the level of suspicion that employees have on each other and on the leadership. If the leadership cannot be trusted by the employees, the impression created in the minds of the employees is that they (employees) are not valued and are being treated as interchangeable parts in a machine. This attitude is likely to fiercely eat into the commitment of such employees (Gunderman, 2009).

Trust has also been deeply associated with improving customer support in the healthcare sector. Gunderman (2009) argues that if physicians feel trusted, they are more likely to reciprocate by giving good service to the patients without any fears. He notes that “In a (trust-based) healthcare organization, fear that mistakes will be detected and punished is a less powerful motivator than a genuine commitment to provide the best care” (Gunderman, 2009, p. 15).

Studies on creating trust-based organizational climate have shown that healthy relationships play a significant role in fostering trust in organizations. Manion (2005) outlines several advantages of a trust-based organization: “it commands trust from the public, has a competitive advantage, can draw the best people, inspire customer loyalty, reach out successfully to new markets, and provide more innovative products and services” (p. 50).

Earning Trust

The significance of trust in an organization has pushed scholars to propose ways which can be used by leadership to develop trust-based organizations.

Communication: This implies that all communication should always be clear and straightforward. There should not be any form of ambiguity that may breed confusion. Duties should be assigned to specific people and it should be made clear what details and specification are to be accomplished.

Commitment: It is very important that the leadership show commitment to agreements made with the employees. If for some reasons this is not possible, then there is a need for immediate disclosure.

Transparency: This is very important. There should be complete transparency of the way an organization is run. Rumors should not be allowed among the employees and information should not be withheld unnecessarily from the employees.

Speedy resolution: Trust is earned when conflicts are solved as soon as they are noted. Refusing to acknowledge the presence of conflicts will erode any trust that employees have in the leadership and this will actually make it harder for the leadership to solve the problem when the situation gets out of hand.

Respect: The leadership needs to show respect to the employees in order to earn trust from them.

According to World Congress (2012), fostering trust in healthcare settings leads to great financial benefits. It has been shown that customers who trust their healthcare insurers associate them with the following qualities “clarity, understanding, caring, generosity, fairness, compassion, flexibility, helpful, believable, effectiveness, warm-hearted, cooperative, friendly, informative, reliability, kindness, up-to-date, accessibility, organization and transparency” (World Congress, 2012, p. 4). Four steps have been suggested for leadership in healthcare insurance to follow in order to earn the trust of their customers.

Step One: The leaderships should have a thorough knowledge of their customers. They should study the behavior and what the customers value most.

Step Two: The knowledge collected about consumers should be used to develop packages that are convenient to the consumers. This will show the consumers that they are understood and that their needs are taken care of.

Step Three: Leadership should engage the consumers in programs that empower them. Programs on wellness behaviors stand to benefit the consumers and in turn the consumers are likely to trust the providers.

Step Four: Transparency is highly appreciated and valued by consumers. This is especially when there is a mistake committed – coming out clearly and explaining the situation including how such a mistake will be effectively taken care of will stir the consumers to have trust in a leadership.


The literature review section has shown that loyalty and trust are indeed inherently connected. It is clear that loyalty cannot be earned before earning trust. For employees to be loyal to a leadership or to an organization, they first have to find some form of trust in the leadership or the organization. Leadership in healthcare organization must be aware of this fact. I believe the following model will work well for healthcare leadership.

A model showing how loyalty and trust are dependent on each other

Employees/customers who trust a leadership/company will intuitively develop loyalty

Basically, the studies reviewed above have shown that building a healthy relationship is a way to ensuring that trust is earned. Leadership is tasked to ensure that it has fostered a good relationship with the employees and also that the employees relate well.

It is amazing that huge compensations are not viewed as a means the healthcare leadership can use to earn employee trust. Specifically, Gunderman (2009) notes that physicians are not really interested in offering services to the highest bidders but rather in working in areas where they can enjoy their work.

There are many values highlighted in the literature section which healthcare leadership needs to embrace in order to earn trust. I am of the opinion that for leadership to earn trust from the employees, it has to engage in a genuine quest for justice and ensure that they are in good friendship terms with the employees. In the table below, I have divided the values highlighted in the findings section into two – those that will result due to the quest for justice and the others that will be products of genuine friendship.

Justice related values Friendship related values
Speedy resolution, clarity, fairness, effective , informative, cooperative, believable, fast, reliable, up-to-date, transparent, communication, and respect Friendly, helpful, flexible, compassion, understanding, caring, generosity, warm-hearted, kind, superior, accessible, organized, and commitment

Table 1 (Showing how the need for commitment of leaders to justice and healthy relationships with employees)

It might be argued that some of the values in one column might be switched to the other column depending on the situation at hand.

It is still amazing to note that the values in the table above do not really require a lot of resources to implement. All that the leadership requires to do is being dedicated to carry out their roles in a just way. Since earning trust seems to be so easy to undertake, a question arises – why is it that it is not a popular practice among leadership?

Trust is earned. It cannot be demanded from customers or employees. Healthcare leadership needs to be aware of this fact. According to Hassan (n.d), trust must be earned every day. Earning the trust of employees is a process which requires time hence the need to continually earn it every day. Due to the difficulty in defining trust, Romano (2003) uses its defining characteristics to define it.

The defining Characteristics of Trust
Referents of Trust Attitudinal




Defines the phenomena to which ‘trust’ refers.
Components of Trust Hypothetical



Defines the sentiments that ‘trust’ contains
Dimensions of Trust Symmetrical



Defines the judgments that levels of ‘trust’ infer

Table 2 (Romano, 2003)

This table makes it clear why it is not possible to demand trust. The defining characteristics of trust are quite abstract and they can only earned. For instance, trust is viewed as an attitude (Romano, 2003) and we know that an attitude displayed is dependent on the relationship that exists.

It should also be noted that trust can only come into play in a social context. Trust therefore is a process that requires nurturing to grow. It takes time and requires commitment – it is conditional. It is after a leadership has earned trust from the employees that the employees in turn become loyal to the leadership and the organization in question in general. Therefore, employees cannot be loyal without first trusting whoever they are being loyal to.


This research paper has dominantly researched on how leadership can earn trust and loyalty from employees. It has focused on what leaders can do right to ensure that employees are and/or remain loyal to the leadership/organization. It has been noted that trust should be earned first and loyalty will then come in naturally. It has also been noted that earning trust from employees is a process which should be carried out persistently. This process is hinged on good relationship between the leadership and employees.

This research paper has great implications which should be noted by leaders in the healthcare sector and generally by all leaders. To start with, leadership should note that loyalty is a virtue that is intentionally cultivated in employees by the leaders. For employees to be loyal, they first have to trust the leadership, and thus for the employees to be loyal or disloyal is all dependent on the leadership.

Leadership should also note that cultivation of loyalty is a process not a one-time action. For leadership to earn trust, and consequently loyalty, it has to continuously foster a good relationship with the employees and ensure that justice, honesty and transparency prevail.

The healthcare field is a participative field and exchange of ideas and information is highly encouraged to ensure best evidence based practices prevail. For this to happen, cooperation among employees in the healthcare sector should be encouraged. However, for these employees to freely share information on their various researches, they will need to build trust in each other. I therefore recommend that studies should be carried out on how employees in the healthcare sector can earn trust from each other.


Gunderman, R. G. (2009). Leadership in Healthcare. New York, NY: Springer.

Hassan, F. (n.d). We can’t just demand trust – first we have to earn it. Leadership. Web.

Manion, J. (2005). From Management to Leadership: Practical Strategies for Health Care Leaders. New York, NY: John Willy & Sons.

McConnell, C. R. (2010). Umiker’s Management Skills For The New Health Care Supervisor. New York, NY: Jones & Barlett Learning.

Romano, D. M. (2003). The Nature of Trust: Conceptual and Operational Clarification. Louisiana State University. Web.

Umiker, A. (2005). Management Skills for New Health Care Supervisors. New York, NY: Jones & Barlett Learning.

. (2012). Measuring the Value of Trust in Healthcare. World Congress. Web.

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"Earning Loyalty and Trust." IvyPanda, 26 July 2019, ivypanda.com/essays/earning-loyalty-and-trust/.

1. IvyPanda. "Earning Loyalty and Trust." July 26, 2019. https://ivypanda.com/essays/earning-loyalty-and-trust/.


IvyPanda. "Earning Loyalty and Trust." July 26, 2019. https://ivypanda.com/essays/earning-loyalty-and-trust/.


IvyPanda. 2019. "Earning Loyalty and Trust." July 26, 2019. https://ivypanda.com/essays/earning-loyalty-and-trust/.


IvyPanda. (2019) 'Earning Loyalty and Trust'. 26 July.

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