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Medical Staff Culture- Part 4

Medical Staff Leader Connection, November 1, 2007

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Dear medical staff leader:

Medical staff leaders need to be aware of diversity-related conflicts between medical staff members as well as those that can arise between medical staff members and the hospital staff.

We have seen that culture is powerful, yet subtle. Culture guides our everyday behavior and offers a context in which to understand, judge, or interpret the actions of others.

The following is a five-step process to help you manage diversity.

Step 1: Understand there is a range of differences
An essential part of the process of managing diversity is to question one's own interpretations and not assume they are universal. Indeed, there is a range of real and acceptable differences. Acknowledging this reality is necessary to embrace the following steps.

Step 2: Develop a framework for exploring differences
Different cultures have different norms and values regarding items as simple as a handshake or as complex as mental processes and learning. Develop a checklist of cultural inventory items to allow a framework for exploring differences including:

• Self and space: handshakes, level of formality, physical distance, body language
• Language and communication: language, eye contact, directness
• Dress and appearance: dress, grooming, hair, personal hygiene
• Food and eating habits: hot/cold, religious beliefs
• Time: deadlines, appointments, tardiness
• Relationships: family, respected others
• Values and norms: culturally-related differences may affect observed behaviors
• Beliefs and attitudes: gender roles, authority, social order
• Mental process and learning: linear, lateral
• Work practices: place of work in life, demeaning work, etc.

Step 3: Develop a successful leadership approach to managing diversity
Leadership is essential to the process since guiding the medical staff through diversity related conflicts requires an organized approach. A successful approach includes:

• Developing clearly articulated core values
• Maintaining flexibility and open-mindedness
• Leading and explaining change
• Creating an environment characterized by respect and professionalism
• Encouraging risks and breaking new ground

Step 4: Assemble a toolkit to manage diversity
Having addressed the first three steps, the implementation of a diversity toolkit becomes more focused and less of a "shotgun" or reactive effort. This toolkit would include:

• Models for direct communication between individuals of differing cultural/ethnic backgrounds with the purpose of ascertaining how these differences might affect the interaction between medical staff members
• Books, tapes, charts highlighting major differences regarding diet, healthcare, and other cultural features
• Policies and procedures related to managing diversity that can be used by the organization concerning holidays, holy days, etc.
• Dietary guidelines to offer appropriate foods for ethnic patients/employees
• Resources for detailed information about particular cultures that are readily available on the Internet

Step 5: Seek to understand
Finally, the fundamental underpinning of communication is essential. This principle, frequently cited by The Greeley Company and attributed to Steven Covey and St. Francis of Assisi, is: "To be understood, seek first to understand."
This four-part series on culture was designed to help medical staff leaders develop practical strategies for handling real time challenges in this area.

Until next time, stay well and be the best that you can be.

Williams Cors, MD, MMM, FACPE
The Greeley Company

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