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Today’s Organizational Change Factor: Internal Culture

Internal Culture

According to Tom Atchison, EdD, whose stated mission is to assist healthcare leaders manage change, “the role of a leader is to facilitate change and build a strong culture by modeling the organization’s mission, values, and vision. The primary goal is to create an organization full of self-managed workers, each of whom understands their role in achieving the company’s vision.”

As president and founder of Atchison Consulting LLC, Atchison has been consulting with healthcare organizations for over 34 years. In his book, Followership: A Practical Guide To Aligning Leaders and Followers, Atchison goes on to remind executives that understanding the basic concepts about change is the foundation to managing it.  He states that change is:

  • a process, one that happens continuously, over time
  • both a personal experience and experiential, noting that not everyone will respond to change the same way and that change can only occur when it is experienced firsthand.
  • best understood when explained practically, for example, how roles will be affected, past, present and future
  • successful when it is simple, particularly at the individual level

However, in Leading Transformational Change: The Physician-Executive Partnership (co-authored with Joseph S. Bujak), Atchison also points out a key factor affecting change: internal corporate cultures. Though cited in one of his earlier publications, the reality of internal cultures and their power to derail or promote efforts for change merits consideration in the present day, a time when physicians and executive administrators are all-too-often on opposite sides of the “how to deliver quality healthcare” table.

The authors state: “the most important factor in understanding how to manage change with physicians and other healthcare providers is the difference between collective cultures and expert cultures. Healthcare systems are comprised of both collective and expert cultures. Many times the difficulty in change management, and even conflicts, can be traced to the fundamental differences between these two cultural phenomena.”

The collective culture is what unites those staff who embrace an organization’s mission, values and vision statements. These highly affiliated employees operate from a place of trust and loyalty, putting others ahead of self, and have advanced their careers by “working in a collegial manner with others. They like to work in groups, tend to avoid conflict and are not high risk takers.”  Whereas, expert cultures have a very different dynamic, with no real need of high trust, affiliation, or mission or value statements. These individuals are motivated more by accomplishment and power, focusing on individual achievement vs. group efforts.

What’s interesting is Atchison and Bujak also indicate that neither culture is right or wrong. Leading for change means aligning the two cultures by understanding and respecting “the unique dynamics of both cultures and using the interactions that most fit the needs of the expert and the collective.” Experts will support a vision for change that includes their self-interest. Collectives will need to know how they fit into that vision and where they can align, based on shared beliefs and values.

Navigating multiple cultures in your organization? Join Tom Atchison and Brian J. Silverstein, MD, Director, The Chartis Group, as they lead Physician and Executive Partnerships: Hard Facts, Soft Skills, Jan. 27–28 at the Clearwater Beach Cluster.

CEOs and physician leaders are encouraged to attend together and learn how to leverage internal culture differences to create a sustainable partnership for effective change.

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