Diagnosis Culture: Every Hospital, Clinic, and Office Has One But Is It Healthy?
Sir William Osler, often considered the father of modern medicine, taught that “the good physician treats the disease; the great physician treats the patient who has the disease.”
If Osler were alive today, he might add:
“And the transformational physician treats the culture that surrounds the patient.”
In today’s healthcare world, sick cultures are just as dangerous as sick bodies.
Ignoring the culture around you isn’t neutral—it’s negligent leadership.
S – Situation:
You’re busy. Patients are waiting. Charts are stacking up.
It’s tempting to put your head down and focus solely on the exam room.
But while you’re seeing patients, the culture around you—staff morale, communication norms, ethical standards—is quietly shaping every outcome you touch.
H – Habits:
Many physicians fall into the habit of “That’s administration’s job.”
We treat the illness but ignore the environment that causes burnout, turnover, and mistakes.
I – Insights:
The culture is your patient.
Like a hidden infection, a toxic culture spreads silently until it shows up as high staff turnover, angry patients, missed details, and exhausted physicians.
Ignoring it won’t save you. Diagnosing it—and treating it—will.
As Dr. Don Berwick (former CMS Administrator) said:
“Culture eats strategy for breakfast.”
You can have great intentions—but if the environment is broken, results will always lag.
F – Formulation:
Shift your lens:
- Pay attention to how teams interact, not just what they produce.
- Ask questions about morale and meaning, not just metrics.
- Model the behaviors you want to see, even when you’re tired, stressed, or out of patience.
Culture diagnosis, like clinical diagnosis, starts with listening, observing, and asking the right questions.
T – Transformation:
When you start treating culture as part of your daily work, you become a different kind of physician.
You don’t just heal bodies—you heal systems.
You create spaces where excellence, safety, and dignity thrive—not by accident, but by leadership.
Take Action
Today, look around your practice or hospital:
- Where do you see trust building—and where is it breaking?
- Where do voices go unheard?
- Where could one word of encouragement change the mood of a room?
The culture around you is either lifting you—or limiting you.
Become a physician who diagnoses both.
