How to Promote Culture Change within Organizations

Co-author Lisa M. Foglia, MD, FACOG 
Maternal–fetal medicine specialist

“I will impart a knowledge of the art to my own sons,” male physicians swore under the original Hippocratic oath. Gender bias in medicine is deeply entrenched, in large part due to organizational culture. Culture change is difficult, but achievable, and should be a priority within institutions and professions seeking to achieve gender and racial equity. 

Culture results principally from relationships, giving individuals a unique and important role in culture change regardless of their titles or positions. Intervention may be driven by leadership (top down) or rank-and-file staff (bottom up.) Culture change in the medical profession may be spontaneous, such as when the #MeToo movement inspired the removal of honorary “walls of white men”; or intentional, such as when medical trainees fill out surveys identifying disrespectful behaviors from faculty and staff, enabling institutional leaders to develop strategies targeting those behaviors. Conducting ongoing cultural morbidity and mortality conferences are a meaningful way of implementing a “yes, and” paradigm: yes, this mistake was made, and here are the changes we can implement to ensure the injury does not continue. 

The paper outlines helpful frameworks addressing polarity management (divergent interests and processes) and the transitions inherent in systemic change. Four cases illustrate ways in which cultural change within contemporary medical organizations can promote professional inclusivity and equity.

Read More: ACOG Celebrates Women in Medicine Month

Source: Women in Medicine journal supplement, Pediatrics, the journal of the American Academy of Pediatrics, September 2021.