Skip to main content

Verified by Psychology Today

Trust

Can a Harvard Degree Actually Reduce Patient Trust?

Re-thinking the public display of a diploma

www.pixabay.com

The common thinking is that a diploma is a mark of the quality of one's education. Many professionals proudly hang their diplomas as a way of establishing credibility and trust with those they serve. And there is definitely merit to this line of thinking. However, given the choice, I have made a conscious decision to forgo hanging my diplomas. Here’s why.

Let me start out by saying that I am very grateful for the excellent education I have received from the three institutions that have awarded me formal degrees. My general decision to forgo any public display of my diplomas is in fact a reflection of my trust in the quality of the education I have been blessed with. I trust that what I have learned and how I have learned to think about problems will show up soon enough in my work. My professors, mentors and clinical supervisors have given me a solid foundation and a good framework for how to tackle a variety of presenting concerns. And, for all of us, at the end of the day (to use a common phrase of our time), if the work is not good, the past achievement of a degree doesn’t matter much.

Related to this, in choosing not to display my diplomas, I am never tempted to lean on them. In the work I do as a front line mental health psychologist with a caseload of several hundred Veterans, I have come to understand that trust is the strongest and most important currency I can earn. I must earn this trust anew with each and every Veteran who walks into my office. If I get complacent, the trust will suffer and the potential to catalyze growth in my patients will be limited.

In order to earn this trust, I want to be mindful about how I create connection with my patients. Leadership structures in the military are important to consider in light of being mindful about creating a relationship where trust may develop.

For those who are unfamiliar with military culture, there are often two parallel lines of leadership in military rank structures. Some leaders rise from within, gaining lived credibility and becoming leaders that their soldiers would take a bullet for. Others may become leaders by virtue of attending colleges or military institutions and entering these roles as officers. (The soldiers in a combat unit would gladly take a bullet for the best of these, but usually not until mutual respect and trust have had time to develop).

There is often a natural tension between these parallel lines of leadership. For example, a West Point graduate who excelled in his or her courses on the theories of modern warfare might be appointed to a leadership position that would outrank someone with 6 tours of duty in a combat zone.

Newly minted officers in these scenarios are often out of touch with the combat tactics that will be most effective within a given theater of conflict. The wisest among these well-educated officers will admit what they don’t know and will humbly learn from their experienced NCOs (non-commissioned officers). They will enter the ranks as servant leaders and will be open to the influence of those who have been in the field. The proud and foolish among them will become a liability to their soldiers—perhaps issuing authoritarian commands based on limited knowledge that may put their soldiers in dangerous or ill-advised engagements as a result.

And those who they are assigned to lead do not receive these newly minted officers from a neutral stance. Decisions made in combat scenarios have very high stakes. It is therefore adaptive for those already in the field to enter the relationship with the mindset that new officers may be a liability until proven otherwise. These newly minted officers (and even sometimes experienced officers who are new to a particular unit) begin with a deficit of trust. In order to earn the trust and win the loyalty of their units, they have to prove that they are effective in their positions.

Early in my career at the VA, I reflected on this, stepped back, and saw that I would probably be perceived as an “officer” (or an "FNG") rather than an NCO. The parallel was too close to ignore—I enter the clinical collaboration with a set of higher degrees and lack of direct military service history.

And in this scenario, anything that heightens this potential disconnect should be reviewed and critically considered. This is probably the most important reason I do not want to lead with my formal degrees—it separates and discriminates, rather than facilitates trust. Being taken into the trust of my patients, and allowing them to “train me up” in their culture and customs has been at least as valuable as all of my formal training experiences.

Hanging educational degrees in my office creates a script that has no place in my office. I want to engage my patients as someone with the same heart as the medics they came to trust in the military, not as an "officer." The best compliment I can receive is when a patient starts calling me "doc" - a special forces medic once explained to me that "doc" is what soldiers call a trusted medic in the unit and for many Veterans, this designation has similar meaning.

So, what hangs in my office in place of formal diplomas? Pictures of local hiking trails, places of beauty that my patients may have also enjoyed as fellow nature enthusiasts, places recognizable and common to our experience that give us immediate points of connection.

I know that hanging a set of diplomas may be a very important show of credibility for some people (especially for those in particular careers). As for me, I have chosen to display my love of the natural beauty we are blessed to enjoy as fellow travelers to a common end.

advertisement
More from Shauna H Springer Ph.D.
More from Psychology Today