Organizational Culture and Its Consequences

Typically comprised of a medical school, teaching hospital, and one or more physician practice groups, the complex organizational structure of academic health centers can be difficult to understand, especially to persons who are unfamiliar with academic medicine. Adding to the complexity, each academic health center has a unique organizational culture. Most broadly defined, “culture” is a shared pattern of basic assumptions shared by a social group about itself. Organizational culture describes these patterns of basic assumptions and related behavior within a defined social environment. Organizational culture has a major effect on faculty health. Some academic health centers may be described as having a “conflict laden” culture, where competition and the associated struggle to remain “on top” are a way of life.

Some academic health center faculty members refer to an environment where compensation is based on a model where “You eat what you kill.” On the other hand, some organizational cultures are more nurturing and, as such, more conducive to maintaining the health of the faculty. “Family-friendly” cultures may offer generous leave to families following the birth or adoption of a child. Likewise, a high priority may be placed on mentoring of junior faculty. In recent times, preventive health and wellness programs have become a part of the organizational culture of some academic health centers. Nonetheless, others persist in the expectation of long work hours, subordination of personal needs like sleep and meals, and self-denial in general. Other changes in organizational culture could enhance the health and well-being of faculty at academic health centers.