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Creating a Healthy Culture in Medicine

August 26, 2021

Written by Clay Smith

Spoon Feed
We thrive when we work in an organization with a culture that encourages us to do our best work and to do the right thing when no one is looking. Here is how we can encourage that kind of organizational culture.

Why does this matter?
What is an organizational culture? It is, “behavior patterns or style that new employees are automatically encouraged to follow by fellow employees.” Or more simply, culture is, “the way we do things around here.” In an organization with a healthy culture, people want to go above and beyond what is required. On the other hand, an unhealthy culture leads to a stifling of discretionary effort and grudging compliance based on rewards or fear of punishment. How can we create a healthy culture?

That’s how we do it ‘round here…
Just like plants can only grow in good soil, so freeing employees to flourish – to do far beyond what is merely required, and to do the right thing when no one is looking – requires these basic ingredients, the seven classic virtues: trust, compassion, courage, justice, wisdom, temperance, and hope. Let’s unpack these seven virtues as they relate to our organizations and smaller teams. If you are assuming a new leadership role, you should definitely read this article, as it presents how Dr. Stoller created a culture as Chair of the Education Institute at Cleveland Clinic.

Trust: A team has confidence each member will look out for the good of one other and do what they have promised. Trust is built by looking out for the interests of others as if they were your own. This kind of selflessness is extremely hard. We are all busy, and to look out for others’ needs as on par with or even more important than our own takes intentionality and work. Leaders model this by serving their team members, modeling discretionary effort, and keeping promises.

Compassion: A team feels the pain of other members when they are hurting or when they need help. This leads to action to help and bring relief. Compassion moves toward the pain of another. This too is counterintuitive, but the reward is amazing. Try it! Leaders model this by showing up in crisis and laboring to make things better for their teams. Like the Navy Seals, we run toward the gunfire.

Courage: A team will, “Do the hard right rather than the easy wrong.” It takes courage to have difficult conversations, resolve conflict, and be vulnerable. Differences are inevitable. If we don’t have the courage to address hard topics and have hard conversations, our teams will wither and die. We also have to have the courage to look at our own shortcomings. Leaders model this by being vulnerable, humble, teachable, and actually having the hard conversations when needed.

Justice: A team ensures members are treated equitably. Whether in regard to pay, position, or performance, all team members are held to the same standards. If a team senses unfair treatment or favoritism, it is poison. Leaders model this by following the process – bylaws, handbooks, standards, codes of conduct – these are written out and agreed upon by all. The leader is subject to and enforces these internal processes.

Wisdom: A team uses foresight and good judgment to make decisions. We won’t settle for short term comfort or take short cuts. The leader models this by constantly learning, reading, asking for advice, and consistently doing the right thing.

Temperance: A team remembers, “Calm is contagious.” When it gets crazy, and it always does, freaking out doesn’t help; and getting angry is especially unhelpful. A leader models this by avoiding anger and keeping a check on his or her expression of emotions. Emotions are not bad, any more than fire is bad. But out of control emotions, like out of control flames, are devastating and damaging to everyone around.

Hope: A team knows there is a bigger goal and believes and works toward making the future better. A leader must have a vision for a better, brighter future and must clearly communicate this vision to his or her team.

Creating an Organizational Culture for the Chest Physician: Creating an Organizational Culture for the Chest Physician. Chest. 2021 Jul;160(1):268-273. doi: 10.1016/j.chest.2020.11.040. Epub 2020 Dec 4.

What are your thoughts?