4 steps to creating a common culture in a medical group

Creating a common culture in a medical group is crucial to creating a sense of confidence, integrity, pride and partnership among physicians and between physicians and an organization.

Howard Drenth, president and CEO of Chicago-based Presence Medical Group, and Martin Schreiber, EdD, vice president of mission for Chesterfield, Mo.-based Mercy and former regional officer of mission and global ministry for Presence Health, discussed culture development at the Becker's Hospital Review 6th Annual Meeting in Chicago on May 7.

According to Mr. Drenth, "Developing a culture is an elusive thing and you're never really there, but we've found a few foundational pillars that may help."

The four steps Presence took to create a common culture included:

1. Holding visioning sessions. In the visioning sessions, PMG executives started by looking at, "this is what we could be, this is what we should be and this is where we are right now," said Mr. Drenth. Having an idea of where the medical group stands, where it wanted to go and how it wanted to define itself helped spur the group's work toward creating a common culture.

2. Seeking out provider input. According to Dr. Schreiber, "It is very important when holding sessions with physicians that the executives allow the physicians to tell their stories and make sure their voices are heard."

Allowing physicians to vote on organizational and cultural matters using clickers is one way of engaging them and helping executives identify strengths, as well as areas of opportunity. For instance, during one clicker activity PMG conducted, the medical group members ranked "provider well-being" as the most important principle affecting the future of the PMG providers, leading the executives to focus on programs that support physicians and reduce burnout.

3. Creating physician focus groups. PMG also invited every physician in the group to company-sponsored dinners to foster a dialogue with the providers using voting activities that were safe and discrete to encourage honesty among the physicians about their thoughts on the organization. PMG executives would also meet with the physicians in focus groups of no more than 10 and ask questions they expected would be a common thread among them, including:

  • Why are you interested in this business?
  • Why did you get into medicine to begin with?
  • What's important to you?
  • What are your unique talents?

Not only did the questions help the PMG executives learn more about their providers, they helped change the way the providers viewed the executive team and build trust.

4. Developing a "Guiding Coalition." PMG adopted the concept of being physician-led and professionally managed and invited practicing physicians who participated in the physician focus groups to join the group's governing board. Engaging physicians on the governing level helped change the tone of how the organization was being run and change the culture.

Using these four steps, the PMG board and physicians created guiding principles to unite the medical group.

Although PMG followed a clear roadmap to create a common culture, the organization still ran into its fair share of road bumps. When faced with a challenge, Mr. Drenth and Dr. Schreiber suggest remembering the following five tips.

1. Listen to your providers with a new ear
2. Build trusting relationships with your physicians
3. Inspire providers to lead with the hearts and hidden talents
4. Organize at all levels to engage your providers; and
5. Seek meaning in your work as an executive by always remembering the voice of the patient

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