Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

What creates a toxic hospital culture?

Val Jones, MD
Physician
October 28, 2015
6K Shares
Share
Tweet
Share

Hospital culture is largely influenced by the relationship between administrative and clinical staff leaders. In the “old days” the clinical staff (and physicians in particular) held most of the sway over patient care. Nowadays, the approach to patient care is significantly constricted by administrative rules, largely created by non-clinicians. An excellent description of what can result (i.e., disenfranchisement of medical staff, burn out, and joyless medical care) is presented by Dr. Robert Khoo.

Interestingly, a few hospitals still maintain a power shift in the other direction — where physicians have a stranglehold on operations, and determine the facility’s ability to make changes. This can lead to its own problems, including unchecked verbal abuse of staff, inability to terminate bad actors, and diverting patients to certain facilities where they receive volume incentive remuneration. Physician greed, as Michael Millenson points out, was a common feature of medical practice pre-1965. And so, when physicians are empowered, they can be as corrupt as the administrations they so commonly despise.

As I travel from hospital to hospital across the United States (see more about my “living la vida locum” here), I often wonder what makes the pleasant places great. I have found thatprestige, location, and generous endowments do not correlate with excellent work culture. It is critically important, it seems, to titrate the balance of power between administration and clinical staff carefully — this is a necessary part of hospital excellence, but still not sufficient to insure optimal contentment.

In addition to the right power balance, it has been my experience that hospital culture flows from the personalities of its leaders. Leaders must be carefully curated and maintain their own balance of business savvy and emotional IQ.  Too often I find that leaders lack the finesse required for a caring profession, which then inspires others to follow suit with bad behavior. Unfortunately, the tender hearts required to lead with grace are often put off by the harsh realities of business, and so those who rise to lead may be the ones least capable of creating the kind of work environment that fosters collaboration and kindness. I concur with the recent article in Forbes magazine that argues that poor leaders are often selected based on confidence, not competence.

The very best health care facilities have somehow managed to seek out, support and respect leaders with virtuous characters. These people go on to attract others like them. And so a ripple effect begins, eventually culminating in a culture of carefulness and compassion. When you find one of these gems, devote yourself to its success because it may soon be lost in the churn of modern work schedules.

Perhaps your hospital work environment is toxic because people like you are not taking on management responsibilities that can change the culture. Do not shrink from leadership because you’re a kind-hearted individual. You are desperately needed. We require emotionally competent leaders to balance out the financially driven ones. It’s easy to feel helpless in the face of a money-driven, heavily regulated system, but now is not the time to shrink from responsibility.

Be the change you want to see in health care.

Val Jones is founder and CEO, Better Health. 

Image credit: Shutterstock.com

Prev

Bad data vs. no data: Defending ProPublica

October 28, 2015 Kevin 0
…
Next

Ease the transition to hospice care in the family home

October 28, 2015 Kevin 2
…

Tagged as: Hospital-Based Medicine

Post navigation

< Previous Post
Bad data vs. no data: Defending ProPublica
Next Post >
Ease the transition to hospice care in the family home

More by Val Jones, MD

  • To solve the overmedication problem, follow the physiatrists

    Val Jones, MD
  • Interested in being a locum tenens physician? Read this first.

    Val Jones, MD
  • Why physicians should not complain about school debt

    Val Jones, MD

Related Posts

  • Don’t judge when trainees use dating apps in the hospital

    Austin Perlmutter, MD
  • When physician pay packages become hospital kickbacks

    Jordan Rau
  • 5 challenges of working in a county hospital

    Pranav Sharma, MD
  • Hospital administrators thinking about no-cost treatment which really helps patients

    John Corsino, DPT
  • What do hospital discounts really mean?

    Robert S. Berry, MD
  • Redefining what a hospital library should be

    Abeer Arain, MD, MPH

More in Physician

  • Physicians turn feelings of frustration and powerlessness into purpose and hope

    Kim Downey, PT
  • Tackling health care conflicts and stereotyping

    Deepak Gupta, MD
  • A physician’s cry in light of world events

    Fareeha Khan, MD
  • 10 things to know about your doctor that will get you better care

    Dawn Sears, MD & Kim Downey, PT
  • Physician burnout reimagined

    Claudia Finkelstein, MD
  • Government surveillance: How electronic prescription records are changing medicine

    L. Joseph Parker, MD
  • Most Popular

  • Past Week

    • There’s no place for “benevolent deception” in obstetrics

      Megan Nix | Conditions
    • Physician burnout reimagined

      Claudia Finkelstein, MD | Physician
    • A physician’s cry in light of world events

      Fareeha Khan, MD | Physician
    • From fishing licenses to gun control

      Mitch Bruss, MD | Policy
    • The synergy of AI and human intelligence in transforming health care

      Harvey Castro, MD, MBA | Tech
    • Navigating COVID: Why it still matters

      Anu Osinusi, MD, MPH & The Podcast by KevinMD | Podcast, Sponsored
  • Past 6 Months

    • Medicare coverage saves lives. Enrolling shouldn’t be this complicated.

      Catherine L. Chen, MD, MPH | Physician
    • Antisemitism is at a historic high not just in other countries, but right here in America

      Joshua D. Lenchus, DO | Physician
    • The erosion of compassion in medicine

      Daniel Luger, MD | Education
    • Emergency department burnout: a cry for change

      Anonymous | Conditions
    • Rising nurse practitioner burnout: charting and work-life balance

      Erica Dorn, FNP | Conditions
    • Pain medicine realities: beyond the opioid crisis

      Richard A. Lawhern, PhD and Stephen E. Nadeau, MD | Conditions
  • Recent Posts

    • The synergy of AI and human intelligence in transforming health care

      Harvey Castro, MD, MBA | Tech
    • Intravenous immunoglobulin for gastroparesis: What happened to me

      Maria Jay | Conditions
    • Physicians turn feelings of frustration and powerlessness into purpose and hope

      Kim Downey, PT | Physician
    • AI and the patient-physician relationship [PODCAST]

      The Podcast by KevinMD | Podcast
    • From fishing licenses to gun control

      Mitch Bruss, MD | Policy
    • 3 key things to do before year end to reduce taxes

      Amarish Dave, DO | Finance

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 10 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • Travel Nurse Practitioner Who Disappeared on Hike Found Dead
  • 'Watch and Wait' With Small Renal Masses: When and How Should Docs Intervene?
  • Gaming the Patent System Can Keep Biosimilars Off the Market for Decades
  • First Gene Therapy for Non-Muscle-Invasive Bladder Cancer Offers Durable Response
  • Non-Covalent BTK Inhibitor Approved for CLL

Meeting Coverage

  • 'Watch and Wait' With Small Renal Masses: When and How Should Docs Intervene?
  • First Gene Therapy for Non-Muscle-Invasive Bladder Cancer Offers Durable Response
  • Oncolytic Virus Shows High Response Rates in BCG-Unresponsive Bladder Cancer
  • Breast Cancer Screening Frequency Makes a Big Survival Difference
  • Noninvasive Therapy Shows Efficacy in Non-Muscle-Invasive Bladder Cancer
  • Most Popular

  • Past Week

    • There’s no place for “benevolent deception” in obstetrics

      Megan Nix | Conditions
    • Physician burnout reimagined

      Claudia Finkelstein, MD | Physician
    • A physician’s cry in light of world events

      Fareeha Khan, MD | Physician
    • From fishing licenses to gun control

      Mitch Bruss, MD | Policy
    • The synergy of AI and human intelligence in transforming health care

      Harvey Castro, MD, MBA | Tech
    • Navigating COVID: Why it still matters

      Anu Osinusi, MD, MPH & The Podcast by KevinMD | Podcast, Sponsored
  • Past 6 Months

    • Medicare coverage saves lives. Enrolling shouldn’t be this complicated.

      Catherine L. Chen, MD, MPH | Physician
    • Antisemitism is at a historic high not just in other countries, but right here in America

      Joshua D. Lenchus, DO | Physician
    • The erosion of compassion in medicine

      Daniel Luger, MD | Education
    • Emergency department burnout: a cry for change

      Anonymous | Conditions
    • Rising nurse practitioner burnout: charting and work-life balance

      Erica Dorn, FNP | Conditions
    • Pain medicine realities: beyond the opioid crisis

      Richard A. Lawhern, PhD and Stephen E. Nadeau, MD | Conditions
  • Recent Posts

    • The synergy of AI and human intelligence in transforming health care

      Harvey Castro, MD, MBA | Tech
    • Intravenous immunoglobulin for gastroparesis: What happened to me

      Maria Jay | Conditions
    • Physicians turn feelings of frustration and powerlessness into purpose and hope

      Kim Downey, PT | Physician
    • AI and the patient-physician relationship [PODCAST]

      The Podcast by KevinMD | Podcast
    • From fishing licenses to gun control

      Mitch Bruss, MD | Policy
    • 3 key things to do before year end to reduce taxes

      Amarish Dave, DO | Finance

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

What creates a toxic hospital culture?
10 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...