The first step to changing the culture in healthcare @muirgray @drsilenzi

by  | in PHYSICIAN

“Look left, look right”, our group leader told us. No, I was not learning to cross the street. Rather it was my first day of employee orientation at the IBM Software Lab over a decade ago. I was fortunate that our CEO was Lou Gerstner, arguably one of the greatest CEOs who has ever existed. Gerstner stepped into IBM in the early 1990s when the company was struggling. One of the key changes Gerstner made was to change the corporate culture of IBM.

“Culture isn’t just one aspect of the game – it is the game,” he stated, and “looking left and looking right” was a metaphor for teamwork, for doing whatever you can to help others within the organization, no matter where they worked in IBM. Software development, marketing, sales, operations, consulting, and others were all united as one IBM. The end result was that Gerstner became a legend for bringing about one of the most remarkable corporate turnarounds in history, transforming IBM back into the powerhouse that it had been.

The medical field could learn something from Gerstner. No matter what hospital you visit anywhere in the world, chances are you’ll see a distinct demarcation between various fields. As youth, most individuals are taught not to generalize people, but in the medical field I find that rigid generalizations about various professions are thrown around all the time, and there is a lack of respect between fields. There is even criticism between hospitals in the same field; “they screwed up the management there,” is something commonly heard. These criticisms are uttered despite the critics’ limited information of the particulars and despite knowing that medicine is an extremely complex field and decisions are rarely black and white.

I am in internal medicine, and I love and take pride in the field I chose. But I could not imagine what we would do without our surgeons who work their rear ends off into the late hours saving lives, I recognize the massive breadth of information that emergency medicine and family medicine physicians need to know, and I cannot thank our nurses enough for the bedside care they provide to patients. The list goes on and on, with pathologists, pediatricians, radiologists, physical therapists, psychiatrists, pharmacists, social workers, and others. And yes, I have had some extremely unpleasant encounters with certain individuals in many of the fields above. A handful of inappropriate individuals in a field, however, doesn’t mean you lose respect for all individuals in the entire field.

For those who work in healthcare, listen for one day to how many positive comments are made about those in other fields and how many critical comments or negative generalizations are made. Chances are the result will astonish you.

I wouldn’t be surprised if our culture of criticism is one of the worst in any field. But changing the culture of the entire healthcare system is not an easy task. I do not have all the solutions, but I think the first step to changing the culture in healthcare is awareness that it needs to change. People must consciously remember that every person has a different and useful role in the system. Changing how we are educated will make an impact as well. The more people in various fields collaborate, whether it be during the training years or even on the job, the more respect between fields will result. Why? Because when you know individuals in other fields on a personal level and you work together toward a common goal, you tend to respect them more.

The bottom line is that a change in culture that values respect and teamwork amongst health professionals will serve our patients better, and it will make the medical field a much more enjoyable place to work. We in healthcare can either work toward a culture change or stand still and become dinosaurs while the rest of the world reaps the benefits of collaboration and teamwork.

Vipan Nikore is an internal medicine resident physician and the President and Founder of the youth leadership non-profit Urban Future Leaders of the World (uFLOW).

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