Tip of the Week: Move Pharmacy Practice Ahead at the Speed of Trust


Pharmacy managers must be transparent and should work to establish an environment where people want to trust one another and feel good about doing so.

Stephen Covey, well-renowned author in business and personal relationships, asserts that trust is “the most overlooked, misunderstood, underutilized asset to enable performance. Its impact, for good or bad, is dramatic and pervasive.”1 The reason trust is so important is that work gets done with and through people. If you trust someone, you will not be concerned about them trying to take credit for your idea or attempting to undermine you. You can share ideas much more readily with them. You can share confidences that you might ordinarily guard, and you can relax knowing that the person you trust will fulfill their obligations, thus allowing you to dedicate more time to the tasks and responsibilities under your more immediate purview.

Gazda and Granko discuss establishing sustainable, trust-based relationships throughout the pharmacy. They reiterate some general points made regarding trust, and also state that trust is necessary for maximizing efficiency and providing high-quality care to patients.2 A previous study also established that companies with leaders who were trusted and who focused their efforts on corporate culture saw increased profitability and higher quality job applicants.

Gazda and Granko also emphasize that trust is not one-way; rather, it is an exchange that requires engagement and buy-in. Transactional trust is comprised of: (1) competence trust, which revolves around acknowledging an individual’s skills and abilities and codifying that by empowering them in decisions and responsibilities; (2) contractual trust, which is based on mutual understanding derived from clarifying expectations, having clear roles , seeing through promises, promoting collaboration, and fostering independence; and (3) communication trust, which establishes a flow of information in a timely fashion, and being truthful in the delivery of this information. These types of trust manifest in behaviors at staff meetings, during performance evaluations, and during discussions of organizational structure and culture.2

The authors state that tying all activities back of the core of pharmacy’s mission to improve patient care is necessary to maintain trust. Tools to build a high-trust team include time and attention; respect; unbreakable values such as putting the patient first; sacrifice for the greater good; and technical proficiency. Pharmacy managers are implored to remove nonessential activities from personnel’s job responsibilities to fuel trust and to rebuild mistrust that has been lost. It is also important not to hover over peers or even direct reports to get the job done.2

The article specifically discussed transactional trust, which is important for laying groundwork. However, the premise of transformational trust, which is akin to transformational leadership, may be even more important. This is built not on individual transactions, but rather is an entire ethos that has developed wherein people put faith in one another simply because they want to; they basically feel compelled to do so in the most positive of ways. Pharmacists must develop trust with patients, coworkers, supervisors, and other health professionals. Pharmacy managers, furthermore, must be transparent and should work to establish an environment where people want to trust one another and feel good about doing so.2

Additional information about Managing Yourself for Success and Negotiation Skills can be found in Pharmacy Management: Essentials for All Practice Settings, 5e.

Shane P. Desselle, RPh, PhD, FAPhA, is a professor of social and behavioral pharmacy at Touro University California College of Pharmacy.


1. Covey SMR, Merrill RR. The Speed of Trust: The One Thing that Can Change Everything. New York: Free Press; 2008.

2. Gazda NP, Granko RP. Establishing sustainable trust-based relationships across the pharmacy enterprise. Am J Health Syst Pharm. 2020. 77(6):419-421.

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