When trust is violated

Abstract

Your thriving practice is situated in a workingclass neighborhood where many families still pay cash for your services. Soon after you learn that your most reliable chairside assistant is expecting her third child, she tells you that she must cease working because of pregnancy difficulties. You hire Marta, an experienced assistant who has moved to your town from another city. You attempt to assess her employment history, but this becomes impossible for a variety of reasons. She is a hard worker, and within a month or two she remembers each patient by name. Your receptionist even remarks that “the kids love her—they say she's so gentle and so patient!” About 3 months after Marta begins work, you notice that your petty cash envelope has only $50 of the usual $100 you always keep on hand. You replenish the funds, and when you check the envelope again in 2 weeks, you notice that money is again missing. You ask your receptionist whether the policy of maintaining petty cash has changed, and she looks back in disbelief as if you are implying that she is dishonest. One attribute that sustains our reputation is trust. The ethical principles of fidelity (keeping one's promises) and veracity (telling the truth) are the pillars of developing and sustaining trust among those around us. Reciprocally, we extend trust to our patients and to our staff. In the context of business management, our ability to identify employees who are trustworthy is as important as our assessment of their skill levels. When our trust in others is violated, our disappointment can be more damaging than even a costly financial loss. A pioneer in the study of the sociology of crime was Professor Donald K. Cressey (1919-1987) of the University of California. Dr Cressey realized that most employees who commit dishonest acts have no intention of doing so when they are hired, nor are they career criminals. Rather, these people succumb to a trilogy of conditions that emerge in their workplace. Three essential conditions induce dishonesty and comprise Cressey's “fraud triangle.”