Toxic Culture and Driving Meaningful Change

Toxic Culture and Driving Meaningful Change Posted By:
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I have recently taken an increased interest in podcasts. One of my favorites is Brené Brown's Dare to Lead series. In an April 2022 episode, Brown (who is a research professor, leadership expert, and author) and her Chief of Staff, Barrett Guillen, reflect upon a recent paper in the MIT Sloan Management Review, "Why Every Leader Needs to Worry About Toxic Culture" by Sull et al. In addition, Brown and Guillen infuse the podcast with their own experiences working with different people who are struggling with toxic culture issues.

In their paper, Sull et al analyzed more than 1 million Glassdoor reviews submitted by US employees of Culture 500 companies (which includes a number of organizations within the healthcare industry). From this analysis, they identified the "Toxic Five" workplace culture attributes that have the most negative influence on employee ratings of culture:

  1. Disrespectful
  2. Noninclusive
  3. Unethical
  4. Cutthroat
  5. Abusive

The paper goes on to describe the costs of toxic culture, both at the individual and organizational levels. Sull et al describe individual costs as increasing burnout, stress, and mental and physical health problems. Organizational costs include escalated expenses due to employee illness, turnover-related costs (these can be up to 2x the employee's salary), and difficulty attracting talent/backfilling vacancies (employees talk to their friends—and many people read employer reviews during the job search process). The paper is full of intriguing details which are too numerous to describe briefly; it is absolutely worth the time to read.

Turning attention to the corresponding Dare to Lead podcast, there is an especially interesting point I would like to shine some light upon: "the fear of being irrelevant." This fear can drive a feeling a shame, causing a person to shut down and even to perpetuate behaviors contributing to a toxic workplace. For example, a long-term, older employee who is not comfortable with technology may strongly resist company transitions to online platforms, for fear of being outshone by newer, younger employees who have a more innate grasp on the technology. As a result, the older employee may become defensive and territorial; sample phrases cited by Brown are "That's not the way we do things around here," and "Why do we need to change now?"

The fear of irrelevance certainly may have different drivers. One concept that seems to be a positive spin on this fear is what Brené Brown describes as the "golden unicorn"—which I think is particularly germane to healthcare settings. The golden unicorn is a person who has been with the company for a long time, and thus has extensive and invaluable organizational knowledge. This person likely both understands the past company culture and ventures, but is curious and excited—rather than resistant—about the future. They can share experiences of past personal failures at the company and how they have grown from them, offering valuable advice for overcoming challenges and adapting to change. They serve as a vital bridge within the organization while modeling positive behaviors that perpetuate a virtuous cycle.

Toxic workplace culture is a reality many experience every day, including those working within the healthcare industry. It is imperative that healthcare organizations seek understanding of the culture their employees experience and commit to meaningful change in problematic areas. I would encourage all of us to think about who you know that is a golden unicorn—and how you can leverage their value within the organization to drive meaningful change.

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Filed under: Miscellaneous , Practice Management/Career

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