Philanthropy

Leadership Giving as a Signal of Trust

Why trustees’ philanthropy correlates with high performance in health care foundations

By Alice Ayres

When individuals are faced with important health decisions, particularly those requiring timely action, they are far more likely to rely on the guidance of trusted medical professionals than to independently evaluate clinical research or outcomes data. This pattern of deferring to credible sources is not limited to health care; it reflects a broader psychological principle that influences how people make decisions across many areas of life, including philanthropy.

The Power of Social Proof

One of the most influential of these decision-making principles is social proof: the tendency to look to trusted experts and peers for cues on how to think or act, especially in moments of uncertainty or urgency. Evidence of the impact of social proof can be found in many facets of life. One powerful example occurred during the COVID-19 pandemic. Researchers in the Czech Republic found that while more than 90% of doctors intended to be vaccinated, the public dramatically underestimated that number, believing only half of doctors supported vaccination. When people were shown the true consensus among physicians, vaccine uptake increased and stayed higher for months afterward. This is the same reason that many pandemic-era vaccination campaigns featured health care workers and political leaders getting the shot.

The same phenomenon plays out in philanthropy. A powerful example comes from the VGH & UBC Hospital Foundation in Vancouver. During a recent $35 million campaign to advance urologic sciences, every trustee made a personal financial commitment. This unanimous support sent a clear signal that the people closest to the mission believed in it deeply and it became a catalyst for broader community investment. As a result, donors responded with confidence, and the campaign nearly doubled its original goal, raising more than $65 million.

This example isn’t an isolated case. Data from the Association for Philanthropy’s annual Report on Giving show that the highest-performing health care foundations are those where leadership giving is the norm. Among high-performing organizations, defined as those in the top 25% in terms of dollars raised for their hospital or health system, leadership groups such as foundation boards and physicians exhibit higher giving participation than their counterparts in non-high-performing organizations. Specifically, 85% of high performers reported giving from foundation board members, compared to just 70% for non-high performers. Physician giving followed a similar trend, with 80% participation in the high-performer cohort, versus only 70% in non-high performers.

This isn’t just correlation; it’s a signal. When board members and other trusted leaders make philanthropic commitments, it demonstrates alignment with the organization’s mission and values. In high-stakes, emotionally driven contexts like health care, donors look for visible cues from trusted insiders like board members to determine if an institution is credible and deserves their support. A prospective donor thinks, “I see that the board has already given, so I don’t need to do as much of my own due diligence to know that I can trust this organization.” In major donor conversations, leadership participation lends credibility to the case for support and removes barriers for others who may be considering a gift. Simply put, when those closest to the organization choose to give, it inspires confidence that others can (and should), too.

Building Trust by Giving in an Era of Suspicion

Signaling trust is especially important in an era where trust in nonprofit institutions has weakened. Public confidence in nonprofits has been steadily eroding, with only 52% of Americans now expressing trust that nonprofits will do what is right. Alarmingly, 48% of people report a lack of trust in nonprofits altogether, and over 80% of donors harbor concerns about whether their contributions make a meaningful impact. This skepticism spans all age groups, but it is especially pronounced among younger generations, where only 1 in 4 young adults believe most people are trustworthy, according to Pew Research. These trends reflect a broader crisis of confidence not only in charitable organizations but also in institutional structures more generally. In this climate, visible and active board engagement is not just a mental shortcut for donors seeking reassurance; it’s a crucial need.

Critically, it’s not about how much you give, but that you give. The power lies in participation, not the dollar amount. A culture of universal board giving sends a compelling message: every trustee stands behind the mission. That collective endorsement builds trust with prospective donors, triggering the same mental shortcut that tells them, “If the people closest to this organization believe in it, I can too.” While the financial support of trustees and physicians is meaningful, the signal it sends may be even more valuable. Leadership giving is ultimately less about fundraising totals and more about creating a culture that fuels confidence and generosity across your entire community.

Trustees can help strengthen this culture by normalizing 100% board giving, not as a requirement, but as a shared expectation of leadership. This expectation is solidified by fostering a sense of peer-to-peer accountability among board members, where giving is modeled and meaningfully encouraged.

Other Ways Trustees Build a Culture of Confidence

While personal giving is a powerful foundation, it is just the beginning. Trustees play a vital role in shaping the culture and success of philanthropy through many other actions, advocacy opportunities and leadership roles throughout the organization.

Showing Up

Engagement with donors is one of the most meaningful ways trustees can contribute. This doesn’t involve asking for money unless you are comfortable doing so. Instead, it’s most often about building authentic relationships. When board members host informal gatherings, invite others into their circles or simply attend events, they make prospective donors feel welcomed, informed and valued. Similarly, a personal thank-you from a board member, whether in person or through a handwritten note, can go a long way in reinforcing a donor’s sense of belonging and appreciation.

Opening Doors

Trustees also play a vital role in opening doors by introducing friends, colleagues or community leaders to the organization. Your participation in events, regardless of whether that event is a gala, a golf tournament or a community health forum, demonstrates leadership and commitment to the organization. When donors and guests see board members actively engaged, it signals that the mission is important and personal.

Shaping Vision

In addition to relationship building, trustees play an important role in shaping the organization’s strategic direction. Your responsibility is not to manage day-to-day operations, but to help set the broader vision and ensure that resources are aligned to support it. This includes providing insight into emerging community needs, helping to prioritize potential programs or initiatives, and offering guidance on philanthropic investments that align with the organization’s mission at key inflection points, such as strategic planning sessions, capital campaign development and annual budgeting reviews. In these moments, you can ask thoughtful questions, surface donor or community perspectives, and ensure that proposed priorities reflect mission impact and philanthropic opportunity.

Sharing Passion

These activities support the organization’s operational success, but they also serve another function: they provide a framework for trustees to share their personal passion. When board members reflect on the initiatives that resonate most with them and why, those stories become powerful tools for engaging potential donors, since they bring the mission to life in a credible and compelling way.

Stoytelling

That storytelling role is essential. You likely carry with you meaningful, personal connections to the organization. When you share why you serve, what inspires your giving or how you’ve seen philanthropy make a difference, you help others see themselves in the story. A well-told experience that’s focused, heartfelt and connected to the organization’s broader mission can move people to action in ways data alone cannot and makes it easier for people to see how they, too, can support the mission.

The process of creating a personal story begins with reflection. What drew you to join the board? Which aspects of the organization’s mission resonate most personally? From there, you can identify a meaningful experience or moment when you witnessed the organization’s impact firsthand or felt the significance of its work to a family member or within the community. Stories are most powerful when they are authentic and emotionally grounded. By connecting that personal moment to the broader mission, you can illustrate how the organization makes a difference every day.

When Trustees Lead, Others Follow

In the end, all these contributions — personal giving, strategic guidance, donor engagement and storytelling — serve a common purpose: signaling that this is an organization worth believing in. Just as patients instinctively trust the recommendation of a physician, prospective donors take their cues from those already closest to the mission. Board members who give, speak up, show up and share their passion help create an environment for others to trust that the organization is worth their support. When trustees lead consistently and credibly, they raise confidence and belief in what’s possible, which in turn raises the funds to make the possible a reality.

Alice Ayres (alice@ahp.org) is the president and CEO of the Association for Healthcare Philanthropy, based in Arlington, Va.

Please note that the views of authors do not always reflect the views of AHA.