Man was probably deprived of such beneficial experience during his development (or isn’t aware of its importance for work culture) . He should be shown that there are other/better ways of work culture, and that it’s best for everybody, including himsef, to resign from his leading role. I don’t think this is Covid19 legacy, this is earlier, more profound. Talking about the leadership at this new institution.
I noted the same phenomenon in my own institution before I retired two years ago. COVID led to a dramatic shift of my partners, especially women with children, from being in the office when "not on service". Collegiality has been a really important element of my career in pediatric pulmonology. Changes with the pandemic led to overall institutional deference to the faculty and fellows with the explicit presumption of responsible use of professional time when not at work. This led to a dramatic change in tutelage of our fellows and less interaction among the partners. Leadership has failed to understand the value, importance, and downright essential nature of face to face interactions. The parallel with the educational assumption that the virtual classroom would be an adequate replacement for in person schoolilng.
I wonder, does the top administrator always network up working for self promotion? That tends to isolate and disengage the supporting doctors and staff. When leadership engages positively with all the subordinate professionals the culture tends to flourish. We work harder for friends that care than a boss that doesn't seem to notice. Staff working hard advances the leader faster so it is win win.
It is sad. Zoom is convenient for meetings across great distances making them more personal. Zoom is destructive locally as it has the opposite effect. You can connect on zoom and pay almost no attention to the meeting. In person you are there an get engaged, you have opportunity to discuss and share items before and after with coworkers, you build relationships and trust needed in years ahead. Zoom and work at home breed disloyalty and breakdown of culture.
Long experience in medicine and the business of medicine has taught me that organizations inevitably come to resemble their leaders, at least in many cultural respects. Even if the current leader is not directly responsible for the current culture, that leader has presided over its continuance. The culture is unlikely to change absent a change (or change of heart) of leader.
Was this culture at the new institution different pre March 2020?
I blame a lot on long standing impacts of pandemic protocols. We are forever different. For a multitude of reasons people in all walks of life just don’t seem as social as they used to be or they have different priorities in who they choose to socialize with.
The culture at our hospital has suffered greatly over the last 4 years. It’s really a shame. Most students / residents / fellows are intelligent - we got into medically school. But many of the skills that make doctors great aren’t based on our IQ but on our ability to be social and interact with common sense with each other and our patients.
I am wondering about this from a different angle. Say a certain company - perhaps a retailer - has terrible culture. Presumably over a long period of time their performance will suffer. They will either identify and fix the problem, or they will go bankrupt.
And in fact we can see the economic landscape is littered with former great retailers that are now gone or at least irrelevant - Woolworth, Sears, Montgomery Ward, etc. etc. So over time that system works, albeit slowly and imperfectly. We can infer there is some sort of “correcting force” when the culture is terrible based on both theoretical grounds and observation.
Medicine and education are two important parts of our society that don’t really respond to market forces of this type to the same degree. There are different drivers. So I am wondering if there is any actual correcting force here? In other words, if this institution has a notably horrible culture and does not change, what happens over the next 20 years? Does it have any effect on the number of people employed there? Presumably the medical care provided to patients, and the education provided to physicians both are substandard at that point. But in and of itself, does that force a change? I am not sure it does. And that concerns me greatly.
If I had to put what makes a great workplace in one word it would be collegiality. People pursuing intellectual inquiries bouncing ideas around, commenting and critiquing, being alright with unprocessed brain farts that have a kernel of possibility but have other features with the bugs not worked out. Being able to discuss cases, papers, thoughts and ideas easily without fears of being called white supremist or racist or whatever. Friends grappling with hard questions in an atmosphere of respect for each other and for the truth. That’s a good workplace.
I think the observations about boosting RVU's and a narcissitic chair explain it all. If the institution values productivity over education/personal connections and the leadership role models a me first attitude, the end product sounds like it's in perfect alignment with institutional values.
If your cardiologist is missing the in person stuff, then set up a weekly in person grand rounds. Invite everyone to the first one. Then just keep doing it.
Of those who show up, create a committee whose duty it is to organise the next weekly events schedule.
Bring snacks. Make it interesting. Invite people out for dinner afterwards.
Start small. If you build it then people will come.
Sense of purpose replaced by “just an employee “ attitude leads to lack of fellowship. Lack of time due to EMRs and “focus on quality” have taken the feeling of commitment out of medicine, in particular. We no longer have to build common bonds with patients and other professionals to be successful.
More and more regulations lead to more and more work. Something has to give. Sad.
Could very well be the expectations/habits of each university are different.
When I was a high school student, I took undergraduate classes at my local public university. The professors in the CS department would invite (for better or for worse) everyone over to their houses at the end of the class for a party. My mom had also been a Master's student in CS, same thing.
Then when I went off to college at a private university, I never once had that happen.
Now, the class sizes at the private university were huge, so I can see a prof not wanting to invite over 500 undergraduates. And at the same time, the people going to the local public university had a variety of age ranges (15-50), and most everyone had a car and could drive to the prof's house, so maybe that made for a more enjoyable party. And the class sizes were way smaller. But at the private university, even in majors with small classes, it was only occasionally that I heard someone went to their profs house. Often having to do with their research groups, or they were a grad student.
One additional factor may be that younger physicians often have working spouses and if they have kids, they are feeling stretched between work and home responsibilities, whereas in past, at least in my division, more faculty had stay at home spouses, enabling the ability to more easily come early and stay late for work meetings, conferences, and collegial social events more easily. I will also note that expectation for parental involvement in school activities and child activities is so much higher now than it ever was 30 years ago. This makes it hard for young physicians juggling their profession and parenting. Trying to stay on top of all the school emails and to do lists is another full time job, or at least feels that way!
As a nonprofit advisor, my most frequent recommendation, only partly in jest, is: “Fire the board.” With this kind of org culture problem (-100 is pretty bad!), change usually does need to come from the top.
Man was probably deprived of such beneficial experience during his development (or isn’t aware of its importance for work culture) . He should be shown that there are other/better ways of work culture, and that it’s best for everybody, including himsef, to resign from his leading role. I don’t think this is Covid19 legacy, this is earlier, more profound. Talking about the leadership at this new institution.
I noted the same phenomenon in my own institution before I retired two years ago. COVID led to a dramatic shift of my partners, especially women with children, from being in the office when "not on service". Collegiality has been a really important element of my career in pediatric pulmonology. Changes with the pandemic led to overall institutional deference to the faculty and fellows with the explicit presumption of responsible use of professional time when not at work. This led to a dramatic change in tutelage of our fellows and less interaction among the partners. Leadership has failed to understand the value, importance, and downright essential nature of face to face interactions. The parallel with the educational assumption that the virtual classroom would be an adequate replacement for in person schoolilng.
I wonder, does the top administrator always network up working for self promotion? That tends to isolate and disengage the supporting doctors and staff. When leadership engages positively with all the subordinate professionals the culture tends to flourish. We work harder for friends that care than a boss that doesn't seem to notice. Staff working hard advances the leader faster so it is win win.
It is sad. Zoom is convenient for meetings across great distances making them more personal. Zoom is destructive locally as it has the opposite effect. You can connect on zoom and pay almost no attention to the meeting. In person you are there an get engaged, you have opportunity to discuss and share items before and after with coworkers, you build relationships and trust needed in years ahead. Zoom and work at home breed disloyalty and breakdown of culture.
I'd set a series of KPIs and measure who does better. Then argue for the best setup and implement it.
KPIs will be criticized as a consequence and a new set of KPIs will be devised.
And repeat. Evidence-based policy.
If this person doesn't like the culture of his job and also isn't willing to leave he can try to start the change towards the culture he wants to see.
Long experience in medicine and the business of medicine has taught me that organizations inevitably come to resemble their leaders, at least in many cultural respects. Even if the current leader is not directly responsible for the current culture, that leader has presided over its continuance. The culture is unlikely to change absent a change (or change of heart) of leader.
Was this culture at the new institution different pre March 2020?
I blame a lot on long standing impacts of pandemic protocols. We are forever different. For a multitude of reasons people in all walks of life just don’t seem as social as they used to be or they have different priorities in who they choose to socialize with.
The culture at our hospital has suffered greatly over the last 4 years. It’s really a shame. Most students / residents / fellows are intelligent - we got into medically school. But many of the skills that make doctors great aren’t based on our IQ but on our ability to be social and interact with common sense with each other and our patients.
We have to be in the same room to do that!!
I am wondering about this from a different angle. Say a certain company - perhaps a retailer - has terrible culture. Presumably over a long period of time their performance will suffer. They will either identify and fix the problem, or they will go bankrupt.
And in fact we can see the economic landscape is littered with former great retailers that are now gone or at least irrelevant - Woolworth, Sears, Montgomery Ward, etc. etc. So over time that system works, albeit slowly and imperfectly. We can infer there is some sort of “correcting force” when the culture is terrible based on both theoretical grounds and observation.
Medicine and education are two important parts of our society that don’t really respond to market forces of this type to the same degree. There are different drivers. So I am wondering if there is any actual correcting force here? In other words, if this institution has a notably horrible culture and does not change, what happens over the next 20 years? Does it have any effect on the number of people employed there? Presumably the medical care provided to patients, and the education provided to physicians both are substandard at that point. But in and of itself, does that force a change? I am not sure it does. And that concerns me greatly.
If I had to put what makes a great workplace in one word it would be collegiality. People pursuing intellectual inquiries bouncing ideas around, commenting and critiquing, being alright with unprocessed brain farts that have a kernel of possibility but have other features with the bugs not worked out. Being able to discuss cases, papers, thoughts and ideas easily without fears of being called white supremist or racist or whatever. Friends grappling with hard questions in an atmosphere of respect for each other and for the truth. That’s a good workplace.
This is so well said. I couldn't put into words why I am not happy in my new position but this is why.
I think the observations about boosting RVU's and a narcissitic chair explain it all. If the institution values productivity over education/personal connections and the leadership role models a me first attitude, the end product sounds like it's in perfect alignment with institutional values.
Solution...
If your cardiologist is missing the in person stuff, then set up a weekly in person grand rounds. Invite everyone to the first one. Then just keep doing it.
Of those who show up, create a committee whose duty it is to organise the next weekly events schedule.
Bring snacks. Make it interesting. Invite people out for dinner afterwards.
Start small. If you build it then people will come.
Sense of purpose replaced by “just an employee “ attitude leads to lack of fellowship. Lack of time due to EMRs and “focus on quality” have taken the feeling of commitment out of medicine, in particular. We no longer have to build common bonds with patients and other professionals to be successful.
More and more regulations lead to more and more work. Something has to give. Sad.
Could very well be the expectations/habits of each university are different.
When I was a high school student, I took undergraduate classes at my local public university. The professors in the CS department would invite (for better or for worse) everyone over to their houses at the end of the class for a party. My mom had also been a Master's student in CS, same thing.
Then when I went off to college at a private university, I never once had that happen.
Now, the class sizes at the private university were huge, so I can see a prof not wanting to invite over 500 undergraduates. And at the same time, the people going to the local public university had a variety of age ranges (15-50), and most everyone had a car and could drive to the prof's house, so maybe that made for a more enjoyable party. And the class sizes were way smaller. But at the private university, even in majors with small classes, it was only occasionally that I heard someone went to their profs house. Often having to do with their research groups, or they were a grad student.
One additional factor may be that younger physicians often have working spouses and if they have kids, they are feeling stretched between work and home responsibilities, whereas in past, at least in my division, more faculty had stay at home spouses, enabling the ability to more easily come early and stay late for work meetings, conferences, and collegial social events more easily. I will also note that expectation for parental involvement in school activities and child activities is so much higher now than it ever was 30 years ago. This makes it hard for young physicians juggling their profession and parenting. Trying to stay on top of all the school emails and to do lists is another full time job, or at least feels that way!
As a nonprofit advisor, my most frequent recommendation, only partly in jest, is: “Fire the board.” With this kind of org culture problem (-100 is pretty bad!), change usually does need to come from the top.