How Clinicians Can Lead Change and Rebuild Trust in Healthcare Systems

Why this conversation matters now

In an era when clinician burnout and patient distrust can feel like permanent fixtures of the healthcare landscape, the most effective leaders are the ones returning the system to first principles: humanity, humility, and shared purpose. The COVID-19 pandemic didn’t invent the cracks between bedside and boardroom—it widened them. Today, rebuilding trust demands more than new dashboards or staffing models; it calls for leaders who can translate across cultures, listen deeply, and act with courage.

That’s the work of Gwendolyn Williams MD, FHM—a hospitalist and associate professor of medicine at VCU Health and a long-time physician leader who served as President of the Medical Executive Committee (a role akin to Chief of Staff) at Sentara CarePlex Hospital in Hampton Roads. Across roles in governance, wellness, and chapter leadership with the Society of Hospital Medicine (SHM), Williams has built bridges between clinicians and executives while keeping the patient—and the person providing the care—squarely at the center.

Her core thesis is deceptively simple: “Healthcare is a business, medicine is an art, and the two do not necessarily marry well — but they must respect each other.” Respect, she argues, is the shortest path to common ground, the precondition for trust, and the first step in shifting cultures that can drift into toxicity under stress.

What follows is a synthesis of Williams’s journey and playbook—equal parts narrative and analysis—on how to lead with presence, rebuild trust after collective trauma, and transform cultures through listening, compassion, and shared accountability.

From Bedside to Boardroom: A Clinician’s Path to System Impact

The throughline: advocacy and early leadership

Williams doesn’t pinpoint a single moment when she “became” a leader. “It happened very early,” she says—well before medical school—through advocacy, community work, and a long string of student leadership roles. That early experience became a throughline in her clinical career as a hospitalist: the discipline of caring for acutely ill, hospitalized patients while navigating the complexity, pace, and uncertainty of inpatient medicine.

As she moved into formal leadership, Williams served as Vice President of the medical staff and later as President of the Medical Executive Committee at Sentara CarePlex Hospital, the physician governance body where bylaws are stewarded, quality is debated, and peer review and professionalism are addressed in direct collaboration with the C‑suite. In parallel, she led the SHM Hampton Roads chapter—“a role that brings me absolute joy”—and under her leadership the chapter earned national recognition.

Pandemic pivot: wellness as a strategic imperative

In January 2020, Williams co‑founded and then chaired a wellness and engagement team. Within weeks, COVID-19 transformed that agenda from a “nice-to-have” to a survival strategy. The focus expanded from patient safety to psychological safety—“really looking at our, not just our patients, but the people who provide care equally and everyone’s wellbeing being collectively important.” The group pivoted quickly, helping clinicians surf the emotional whiplash of the unknown while partnering with administrative leaders to translate risk, resources, and reality in real time.

The lesson: wellness cannot be episodic or ornamental. It must be built into the operating fabric, with governance attention and clinician voice. And it requires leaders comfortable advocating in both directions—explaining the operational constraints that administrators face and, just as importantly, making the human case for frontline needs.

Closing the Distance Between Clinicians and Executives

The gap is real—and relative

Williams refuses to romanticize the divide. “The gap is subjective,” she notes. “It’s relative to the group you’re a part of and who’s around you.” What widens the space, she argues, is less malice than misunderstanding: executives don’t always grasp how decisions land at the bedside; clinicians don’t always appreciate the constraints of capital, regulation, or system tradeoffs. The work is to translate.

Translation starts with posture. “The goal is not to win,” Williams says. “The goal is to find common ground.” In practice, that means entering discussions not as combatants but as collaborators serving a single team: patients and community. That shift of frame—from sides to shared purpose—invites curiosity and opens room for solutions.

Listening as leadership muscle

If translation is the work, listening is the muscle that powers it. Williams is candid about how hard it is: “In healthcare, we think we’re the best listeners. We are the worst listeners.” Her humbling moment came not in a boardroom but at home. Lost in mental to‑dos, she missed her three‑year‑old’s words until her daughter grabbed her face: “Mommy, you are not listening to me. I need you to hear me.” That, Williams says, is the daily corrective leaders need: hold space before making a point; reflect before reacting; hear the person, not just the problem.

This is not soft-skills garnish; it’s operational strategy. Leaders who listen surface constraints earlier, defuse conflict sooner, and design systems people can actually use. Listening is also the wellspring of dignity at work—the experience of being seen and taken seriously—which becomes fuel for effort in high‑stress environments.

Power and humility

Williams’s theory of power is as much ethical as it is practical. “Power is something to be respected,” she says. “If you do not have the humility to bend down and pick up power that someone has laid at your feet, you should not have it.” Exercised well, power invites participation; misused, it breeds fear and disengagement. Her meetings model belonging: kids’ voices in the background are okay; contributions are welcomed in their own time; the culture prizes candor without bullying. When leaders normalize humanity, people take risks on behalf of patients.

Kindness, accountability, and the courage to be better

Williams is blunt about cultural drift in parts of healthcare: “The culture of healthcare is extremely abusive. It’s extremely toxic because people don’t take the time to think about what they’re going to say and how they’re going to say it.” Her remedy is not performative niceness but principled kindness. “Kindness is not weakness. It’s a great strength.” Coupled with accountability, it changes trajectories: apologize and mean it, then improve the behavior. “Don’t be sorry. Be better.”

Rebuilding Trust After Collective Trauma

Two fronts of trust: communities and the workforce

Trust “takes seconds to break and a lifetime to repair.” Williams argues that healthcare must rebuild on two fronts at once. The first is trust with patients and communities—especially those long underserved. The second is trust with the workforce itself, frayed by the pandemic and its aftermath.

On the community side, trust grows when the system engages with people as whole humans. “Focus on our patients and our communities beyond their medical illnesses,” Williams urges, naming food insecurity, housing, education, and health literacy as practical starting points for cross‑sector collaboration.

On the workforce side, acknowledging trauma is non‑negotiable. “We need trauma‑informed leaders,” she says, those who know that a “keep calm and carry on” message after mass loss and prolonged moral distress is not only unrealistic—it’s harmful. In Williams’s practice, that looks like debriefs after code events, moments of silence, and explicit permission for clinicians to experience and process big emotions. Safety lives not just in personal protective equipment but in psychological safety: the shared belief a team can speak up, ask for help, and be human.

Policy levers matter: Lorna Breen and beyond

Culture and policy must move together. Williams points to the Dr. Lorna Breen Heroes’ Foundation as a model for changing the structural incentives that punish vulnerability, particularly invasive mental‑health questions on credentialing forms. Removing those barriers, she argues, is a concrete step toward treating clinician mental health as a safety issue, not a stigma.

And, she cautions, symbolic efforts won’t cut it: “As much as I like pizza—I’m a New Yorker—a pizza party is not going to fix this.” Real rebuilding requires investment, measurement, and hard choices about what gets deprioritized so that people can recover.

Programs, Practices, and Stories That Move Cultures

Wellness and engagement as an engine for change

Williams’s wellness and engagement team, launched in early 2020, is a case study in making wellbeing actionable. The team’s anchor ideas—psychological safety, bidirectional communication, and parity between patient and caregiver wellbeing—helped leaders justify time for debriefs, normalize asking for help, and keep executives close to the frontline signal in the most chaotic moments of the pandemic. The pivot was not about perks; it was about codifying humane practice under pressure.

The SHM chapter as a micro‑culture of belonging

As President of SHM’s Hampton Roads chapter, Williams emphasizes culture-setting as core work: celebrating contributions, modeling inclusive meetings, and protecting autonomy so leaders can grow without micromanagement. The results—recognition at the national conference and a pipeline of energized leaders—flow from design choices that prioritize belonging. In Williams’s telling, joy is not a by‑product of a healthy chapter; it’s a leading indicator of future impact.

Translating needs: from home visits to medication access

On any given day, the bridge work is granular: making the case for affordable medications, explaining why timely home health visits post‑discharge matter for frail elders, or advocating for collaboration across specialties and even across systems so that a patient’s care plan is coherent. Williams names these not as abstractions but as the daily content of translation: clinician stories that help administrators see the “why,” and administrator context that helps clinicians understand the “how.”

Choosing peace over chaos in moments that matter

Williams tells a domestic story with professional implications. After an exhausted morning, she lashed out over unwashed bottles and later apologized. Her husband asked a single question: “Why did you choose chaos over peace?” The question landed. In hospital dynamics—an undrawn lab, a delayed study, a scarce resource—the reflex to escalate is powerful. Choosing peace is not avoidance; it’s a strategy to “funnel passion,” to invite people into a calmer space where problem‑solving becomes possible. It takes time, she admits, and “time is the thing we always feel we don’t have,” but embracing that time is how change sticks.

Leadership, Wellness, and Community Collaboration: The Intersection

A round table with no head

Williams’s metaphor for the future is a round table with no head: clinicians, executives, patients, and community partners approaching problems with equal dignity and voice. “If I’m in the room where it’s going to happen, I need to not only have a voice, but champion other voices that are in the room—and the voices that can’t be in the room.” That’s what it means to keep “the human in healthcare.”

The practical implications are many: bring community organizations into care planning; align on shared outcomes beyond volume and RVUs; publish staffing and safety metrics alongside patient‑experience data; build feedback loops that reach the people who can act. Respect the art and the business—and make them respect each other.

Compassion as operational design

Compassion, for Williams, is not the impulse to fix everything immediately. It’s “the desire to be there, understand, be mindfully present, and then ask: How can I help?” That stance helps leaders avoid two traps: dismissiveness (which erodes trust) and over‑promising (which breeds cynicism). Compassionate leadership aligns expectations with resources while making it unmistakable that people’s experiences matter.

Redefining success: excellence over perfection

Perfection, especially in complex systems, is a mirage. Williams reframes success as excellence pursued together: agreeing on goals, iterating in the open, and measuring progress with humility. When teams internalize that frame, they are more likely to surface problems early, learn quickly, and persist through the messy middle of change.

Actionable Takeaways for Health System Leaders

Build the bridge on purpose

1. Start with respect, not righteousness. Enter tough conversations assuming the other party is acting in good faith within real constraints. Name the shared goal—healthy patients and a healthy community—at the outset.
2. Translate relentlessly. Ask clinicians for the story behind a request (the patient, the risk, the workflow). Ask administrators for the tradeoffs behind a decision (financial, regulatory, operational). Publish those explanations.
3. Institutionalize listening. Design meetings where listening is a discrete step: reflection rounds, structured “hold space” practices, and real pauses before decisions. Reward leaders for listening behaviors.
4. Make wellness structural. Treat psychological safety like hand hygiene: expected, measured, and led from the top. Normalize debriefs after adverse events, invest in peer support, and make time for recovery part of the schedule, not after-hours charity.
5. Adopt trauma‑informed policies. Remove stigmatizing mental‑health questions from credentialing, simplify access to counseling, and train managers on recognizing moral injury and responding without punishment.
6. Model kindness and accountability. Coach leaders on giving critical feedback without humiliation. Replace “I’m sorry” cycles with concrete improvement commitments. Track whether behavior changes.
7. Share power. Build round‑table structures—co‑chaired councils, clinician‑administrator dyads, patient/community representatives with real votes—so that decisions travel on more than one rail.
8. Choose peace in the moment. In escalation-prone settings, equip leaders with language and tactics to downshift the temperature (acknowledge emotion, restate goals, propose a next step). Protect the time that calm requires.
9. Measure trust. Don’t guess. Use pulse surveys, focus groups, and exit interviews to quantify trust among clinicians and staff. Share results transparently and act visibly on what you learn.
10. Aim beyond the diagnosis. Partner with community organizations on food, housing, education, and health literacy. Build shared dashboards to track impact outside hospital walls.

Conclusion: Respect as Strategy

Williams’s leadership philosophy is not theoretical—it is hard‑won at the intersection of human vulnerability and system constraint. The prescription is clear: honor the art and the business; design for listening and psychological safety; lead with compassion and accountability; build a table where every voice matters. Do these things, and the distance between bedside and boardroom begins to shrink.

“Take away titles, take away white coats,” Williams says. “We’re all human beings and we have a shared humanity.” In a system that has survived crisis after crisis, that reminder is not sentimentality. It’s strategy—one that just might rebuild trust where it matters most: between people who heal and the people they serve.