The Importance of Culture in Health Care

By: Kathy Ruscitto

A few months ago I had the opportunity to hear two physicians talk about their careers as they received recognition. Dr. Kara Kort, a surgeon, and Dr. James Tucker, a family physician.

Both are esteemed by their patients and colleagues. They are passionate about the profession they chose and the work they do as physicians and leaders in their disciplines.

As they spoke, the words, tone, and tears they shared all spoke to service to others. They chose medicine to help people.

In his remarks Dr. Tucker thanked to his patients for letting him be part of their villages, lives and families.

Dr. Kort talked about how being vulnerable in her own life experiences , enabled her to help patients at critical points in their lives.

Health professionals often choose their career to contribute to improving  the  health of others. Clinicians  value their  professional expertise, training, the ability to give their patients high quality care , and collegiality across a health care system.

The reality is they are facing complex systems that require automation, long hours to balance their complex demands, and frustrated patients with payer barriers. We knew we were going to face a large segment of retirements across physicians and nurses, COVID accelerated those trends. The current system feels broken to many clinicians and patients.

In an article in Medscape, Drs. Toprol, Verghese and Pearl discuss Physicians’ roles in accelerating  system changes to improve patient care. They all suggest some of the challenge is clinician resistance to letting go of old culture, and adopting new more efficient options like telemedicine. Changes that allow patient access and follow up during workforce shortages is better than delayed, or no care at all.

Other experts feel the most important investment we can  make is a shift away from fee for service care to value based care, aligning incentives around patient outcomes. 

While these examples may be part of structural system redesign, shared culture is equally important.

Medicine is a team sport. It requires collaboration across a spectrum of disciplines, workforces, and payers. We must listen and value the input of the health professionals if we are to rebuild our health systems culture and workforce to continue to provide high quality patient centered care. System redesign alone, in the absence of shared culture will not resolve our issues.

Right care, right time, right place, right cost is often included in marketing and headlines these days. The underlying assumption being we have a shared culture of achieving this care. 

As you plan retreats , strategy and future goal sessions, spend time discussing culture and clinician input into our future in health care. It is the most important thing we need to do to meet our challenges.

Resources:

Healing the Professional Culture of Medicine – Mayo Clinic Proceedings

To End Burnout, Doctors Must Change the Culture of Medicine

https://hbr.org/2022/09/5-steps-to-restore-trust-in-u-s-health-care

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