In health care, we often focus on metrics, technology, and clinical protocols. But there’s an invisible force that permeates every patient interaction, shapes clinical outcomes, and determines whether clinicians stay or leave: organizational culture.
Culture isn’t just a buzzword—it’s the foundation on which everything else is built. A strong, supportive culture doesn’t just feel better; it delivers measurable improvements in patient satisfaction, clinical outcomes, and operational stability.
What exactly is health care culture?
“Culture is what you feel when you walk in,” explains David Schillinger, MD, Chief Medical Officer at SCP Health. “It’s the string that runs through the company—something you can feel and calculate when you walk into a room, a department, or an organization.”
Culture encompasses shared values, behaviors, and practices that characterize how people within an organization interact and work together to achieve goals. Dr. Schillinger describes it as the “personality,” a strength that people can feel immediately upon entering a department.
But culture isn’t something that just happens. The most effective health care organizations create “culture by intent” rather than allowing “culture by default” to take root. When leaders deliberately shape culture around core values like respect, courage, collaboration, and agility, they create an environment where both clinicians and patients can thrive.
A patient-centered culture is a strategic imperative
In high-functioning health care environments, every conversation has the patient at its center. This might seem obvious, but Dr. Schillinger notes that in many settings, conversations revolve around what’s better for individual staff members or the organization rather than what’s best for the patient.
“We may disagree on how we get to the patient in the center or how we optimize what we do with that patient at center,” Dr. Schillinger explains, “but we shouldn’t be debating whether it’s better for me or better for you.”
This patient-centered focus is evident in departments where:
- Staff members work collaboratively rather than competitively
- Clinical teams communicate effectively across disciplines
- There’s a sense of organized chaos rather than disorganized panic
- Everyone understands the boundaries of getting to good outcomes
How clinician satisfaction directly impacts patient experience
While the patient is always at the center of discussions, it’s clear from Dr. Schillinger’s decades of experience as an emergency medicine physician that patient experience is inextricably linked to clinician experience: “You will not get the results you want if the clinician isn’t satisfied in their job or isn’t fulfilled in their job.”
This connection manifests in tangible ways. Dr. Schillinger describes a simple barometer for measuring clinician engagement and the patient experience: “At the end of care, you came in with abdominal pain, you feel better and ready to be discharged, and I say, ‘I want you to follow up with your doctor in three days.’ If they say, ‘Well, can I see you? Do you have an office?’ then you’ve hit the mark.”
Patients won’t necessarily think your medicine is better—they think you listen better.
In contrast, a struggling culture reveals itself through:
- No smiles among staff members
- Compassion fatigue, particularly among nursing staff
- Eye-rolling or arms crossed when talking with patients
- Staff just “doing their jobs” rather than connecting with patients
4 evidence-based strategies for building a culture that works
Creating a positive health care culture isn’t about posters with inspirational quotes. It requires deliberate action from leadership. Here are key strategies that make a difference:
1. Recognition and reward
“If you want to build a team, it should be based on recognition and reward, not on pointing out what they did wrong as the only conversations you’re having,” Dr. Schillinger advises. This approach creates psychological safety and encourages continuous improvement.
Simple actions make a difference: “I don’t think there’s a meeting that I end without thanking people or saying ‘good meeting,'” he notes. He suggests that hospital administrators might consider getting their first cup of coffee in the ED each morning, ensuring staff don’t only hear from leadership when something goes wrong.
2. Accountability with support
Creating a culture where people can hear constructive feedback requires trust and 360-degree reviews to help clinical leaders understand their strengths and weaknesses from multiple perspectives.
“If you don’t know your weaknesses, you can’t get better at what you do,” he explains. The most common feedback? “Communicate, communicate, communicate. Don’t dictate, dictate, dictate.”
3. Invest in team building
Team-building initiatives aren’t luxuries—they’re essential operational investments. Educational opportunities, including outside motivational speakers, can transform department culture. However, their impact is maximized when leaders establish clear expectations for participation.
4. Leadership by example
Leaders must embody the culture they wish to create. Dr. Schillinger shares that he keeps a note on his computer that simply says “listen” and another that says “be present”—reminders to practice the behaviors he expects from his team.
“In a really good team, it’s hard to figure out who’s in charge,” he observes. The mantra “no one of us will be as smart as all of us” encapsulates this collaborative leadership approach.
Measuring the ROI of cultural investment
Investing in culture delivers tangible operational benefits:
- Reduced turnover: When clinicians feel supported, they are less likely to leave, reducing costly recruitment and onboarding expenses.
- Better clinical outcomes: Patient-centered cultures tend to produce better health outcomes, reducing readmissions and complications.
- Improved patient experience: Patients can sense when clinicians are engaged and satisfied, directly affecting patient loyalty, patient satisfaction and HCAHPS scores.
- Improved efficiency: Collaborative cultures waste less time on internal conflicts and more effectively navigate challenging situations.
Culture unifies values across health care teams and departments
Finally, Dr. Schillinger emphasizes that cultural values should be consistent across all aspects of life: “Whether it’s the company, the department, or your family, you should have the same values,” he says. This alignment creates authenticity that both clinicians and patients can feel.
In health care’s increasingly complex landscape, the organizations that thrive will be those that recognize culture isn’t a soft, nice-to-have element. It’s the bedrock upon which patient care, clinical excellence, and operational sustainability are built.
When we invest in creating departments where clinicians want to work, we simultaneously create departments where patients want to receive care.
