Are Culture Wars Winnable in Healthcare?

In politics, culture wars typically are fought on the battlefields of income inequity, social disparities and disparate education levels. The uniforms of the soldiers are distinct by the color of their collars or their congressional district.

In science, a culture is an artificially created environment where things grow, like a bacterial culture in a culture tube or Petri dish.

In the workplace, culture is about how things get done and how it makes you feel to work in a place. Organizational behaviorists are paying a lot of attention to it lately, since, they claim, culture impacts everything from employee satisfaction and turnover to ecosystem or cluster success to startup success to the size of a given innovation or research quotient (how much goes in compared to how much comes out).

A key leadership challenge is to create a culture or change one that is toxic or non-productive. The culture of sick care companies (some call them hospitals), in many ways, are unique:

1. The players are fiercely independent and don't usually play nice with each other.
   
   
2. It is only recently that sick care has become a team sport.
   
   
3. Every hospital system has a unique culture with layers and layers of history and rules of engagement that define it. The culture of a university hospital is different from a safety net hospital or a VA hospital or community hospital.
   
   
4. Patients are exposed to a given hospital culture and can feel the difference.
   
   
5. As more and more doctors are employed, culture plays a bigger and bigger role in whether they will stay or leave.

Culture seems to be more important to millennials than other demographic groups: 

1. Changing a culture can take generations. Investors and workers aren't willing to wait that long. In most instances, patients don't have a choice.
   
   
2. You can never really escape your history. You can revise it. You can ignore it. You can put lipstick on a pig. But, in most instances, doing so leads to ineffective change.
   
   
3. Hiring a franchise player to get you to the playoffs rarely works in sick care any more than the NBA or the NFL.
   
   
4. Non-profits, mission driven organizations and for-profits all have the same problem-turf wars and office politics kill the best of intentions and innovation.
   
   
5. The followers don't trust the leaders.
   
   
6. It is a very high stakes enterprise.

All hospitals, and many startups, are filled with people who have a warrior mentality and the culture encourages it. The cost is suicide, depression, loneliness , anxiety and divorce.

In most instances, I propose, organizational culture wars are not winnable in the short term. So, if you are considering signing up to fight them, maybe you should reconsider and just find a place where you feel valued and can have a nice day doing something worthwhile. Take a page out of the Pentagon playbook-just declare victory and go home.

Arlen Meyers, MD, MBA is the President and CEO of the Society of Physician Entrepreneurs.