5 Essentials for Creating Culture

Essentials for Creating Culture

The new buzzword for start-ups in healthcare is without a doubt the word culture. A quick look at Harvard Business Review finds 7,153 articles that center around culture in the subject of managing organizations alone. There’s all kinds of culture-talk happening. There’s:

• corporate culture
• data-driven culture
• culture of originality
• emotional culture
• continuous improvement culture

When a word is presented at every event or tossed back easily at lunch with a taco and a mojito, it’s easy for it to lose its intended meaning. However, culture is more than a buzzword. It’s actually a crucial component to customer satisfaction and specifically in the healthcare space, to peoples outcomes and quality of life. Culture is far more than a box that needs to be checked off when you’re building, or redesigning, a company, it is the key to how effectively you’ll not only reach your target audience but in the end how loyal they’ll be to you. And, considering it takes far less to retain a patient than to attract new ones wouldn’t this be a great goal to have?

1. What do people mean when they say culture?

As per businessdictionary.com culture is…”social heritage of a group… It is a pattern of responses discovered, developed, or invented during the group’s history of handling problems which arise from interactions among its members…”
As per Wikipedia, “culture is a central concept in anthropology, encompassing the range of phenomena that are transmitted through social learning…”
Key in these definitions is that culture is intimately tied to ones’ audience. There is no way to build, refine or transmit culture without looking to the perception of ones’ members. You can not build an effective culture in an ivory tower. There is most definitely a back and forth. Culture works only when built (or tweaked) to address previous experiences (social learnings) with members.
And, a successful culture only comes into being if the following four things are taken into account.

2. Culture isn’t created in a Vacuum.

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Here’s the thing, you can’t just start listing your vision and values in an office meeting and call that your culture. And you certainly can’t duplicate another company’s culture and call it your own. Culture is created over time and you need one crucial element that ignites the entire process: Your consumers. Your target audience.

Who are your consumers and what do they need, want and expect from you? Before any corporate culture is built, you must know your audience. Culture isn’t created in a  vacuum.
Business, in general, is no longer a function of push it out and have people accept what you’re selling (that may have worked with past generations but that is no longer true now that fresh generations are at the forefront in our society) now it’s truly a matter of pull from them: what do they need, what will they respond to, how do you reach them, how do you keep them? Until you know these things, set your culture aside, it may be your ‘ideal’ but that doesn’t mean anything unless it is also the ideal of your audience.

3. Talk to Your Intended Target.

If you are in the Health Care space, consumer research is absolutely necessary to determine the following answers:
What information do your patients need prior to choosing you as a healthcare partner? What information do they need before stepping foot into your practice? What do they expect once they arrive? What does a patient require as they leave, and beyond, your care?
Once you hear from them, build processes that meet said needs. Consequently, patient experience and satisfaction will correlate positively. If you develop a mission that doesn’t align with the needs of the intended recipients, it will fall on deaf ears. You must find out the following:

• Expectations
• Needs
• Wants
• Pain points

From the answers to these questions, build your mission, processes and internal culture accordingly to hit each and every one of them head on. If you do this successfully not only will your practice flourish but the loyalty to your practice will be second to none.

4.  Build Your Culture from the Outside In.

Once you know who your target demographic is and what their needs are, you can hire based on who can accomplish the tasks needed to meet the clients’ needs. Only after this happens people, practices, processes, and place can be determined.
If you choose to hire before your culture is fully formulated and put it into action it is likely the training you’ll need to do with your employees, so that they can better convey the culture will take away from any benefit you thought you had in filling your work force early.
Take the time first to know who is needed to best fit your culture, who will transmit authentically all that is intended, and then hire accordingly. Once your internal culture matches that of what is expected from your external audience you have the recipe for success, efficiencies, positive outcomes and loyalty.

5. Patient Driven Culture vs. Doctor Driven Culture

Right now the health care space is seeing the beginning of a paradigm shift. Patient-driven culture is growing because the doctor-driven culture has shown itself to be lacking.  In the past patients were apt to take a doctor fully at their word, never question a diagnosis or a set protocol for recovery. Now, not only have the times changed but the generations with it and they demand more; they demand a voice, they demand a partnership, they demand a seat at the proverbial table of their own healthcare.
As we are in the midst of this shift we’re finding not all practices are getting the memo. Until such time that we are all speaking the same language practices will find patients will look elsewhere for care. Now care is literally only a click away and the newly empowered generations are quick to go that route or to use easily accessibly walk-in-clinics and they don’t feel history with a practitioner is as important as convenience. Once healthcare providers and healthcare recipients align the efficacies of our system will greatly improve. The current burdens, such as wait time, costs, and even (re)occurrences of diagnoses will decrease.
A patient-driven culture creates the empowered patient which encourages ownership of their own health. Healthcare is no longer a ‘silver bullet’ directed by doctor but, better yet, decided upon, analyzed by and bought into by the patient. Study after study proves that the more the patient is empowered the more committed they’ll be to their own care and the more committed they are will lead to better outcomes and lower healthcare costs and a higher quality of life.
Here’s to health. Here’s to happiness.

Communicating in the New Millennium


Strauss and Howe’s categorization of the Millennial puts the birth range from 1982-2004.

As the world spins faster and faster into the digital age, companies need to know that they are communicating with two distinctly different consumers and workers. Baby Boomers and Millennials find themselves trapped in lockdown of miscommunication. They may speak the same language, but a translator is needed to bridge the gap of understanding. Particularly in marketing to these consumers and in hiring boomers and millennials, businesses must approach each group with the care and uniqueness that sets them apart.

I’ve made it easier for you to find the distinctions that drive each generation and then how to communicate, motivate, and cooperate with these two groups of people.

baby boomers-6Baby Boomers

Born approximately between the years 1946-1964, these 52-70 year olds came into the world during a time of conflict. World WarII was barely in the rear view mirror, and many of their parents, those of our Greatest Generation, fought in that war so it was never far from conversation. The Vietnam War — a highly contested and volatile war —trailed closely behind, while the Civil Rights Movement and Martin Luther King, Jr. dominated the news. These boomers experienced social changes in women’s rights, birth control, and abortion. During their formative years, the Berlin Wall was built and the Cuban missile crisis kept them practicing drills at school.

They were also born during a time of expansion. The world saw the 1st man on the moon,
Televisions became more widespread and available to the masses, and
suburbs were created. Boomers lived during the time where the adage of work hard and reap the benefits was never more true. The economy was booming and people were living well after the war, up until the early 70’s. This set of kids saw their parents going to college and working in ‘traditional roles’ in traditional fields, for them it was unlikely their parents were entrepreneurs.

This is a generation that:

Is patient and not at all entitled – They saw their parents work for all they got, and they had those same expectations instilled in them. They were raised by the Greatest Generation who lived as though at any moment the bottom may fall out again. They were conscientious spenders and hard workers.

Had a voice – This is the generation of marchers/protesters and flower children. They saw great conflicts in their life times, and the pump was primed for them to jump in and lend a voice and a hand.

Are collaborative workers – They learned when you join forces through their marches and protests that there is more strength in numbers and that followed them into the workforce. They were happy to work as a team and leave their own interests at the door for the greater good.

Put themselves last – this generation was far from coddled as their parents were busy re-establishing their families, getting educations and making a new life for themselves. These kids were independent and were expected to step up and help the family as a whole. These kids are also the ‘sandwich generation’ – carrying for both their kids as well as their parents, this, in and of itself, left little place for ‘me’ time.

Experienced death differently and less ‘intimately’ than generations past:  Aging in America became a business during this time. While the process started in the mid-50’s to establish elderly homes it was really in the 60’s – 70’s that this business model burgeoned and started to take in great numbers of our older population. Baby Boomers watched their parents…their heros…die in homes and institutions unlike any generation prior. For example when Boomers were children they likely saw their parents tend to their grand-parents through the end-of-life in their own homes. It was not unusual to see Grandpa take up residence in what used to be the family living room. Therefore this new ‘outsourcing’ of end-of life put both an emotional stressor on their shoulders, as they felt as though they were abandoning their parents, and a fiscal stressor on their pocketbooks. Now, with life extended they had to cover costs for nursing homes and/or they had to build in travel expenses to visit their continually aging parents possibly across many states. This was far from an intimate was to die, this was death in the age of commercialism and capitalism.

Are fiscally aware but not necessarily prepared – this generation saw great growth in the economy and for some time tremendous strength in a growing middle class but if they didn’t, or weren’t able to, prepare accordingly for a rainy day, this generation also saw the dramatic shrinking of that very middle class with the passing years. Boomers also experienced a significant shift in power and the reality of our dependence on other countries for things so important to our everyday lives as oil. This generation remembers quite vividly the gas shortages and the lines at the pumps with their babies in tow, during the 70’s. They also had the aforementioned hardships of carrying for multiple generations which often depleted their savings and the likelihood that they would over commit to savings such as 401Ks, according to The Fiscal Times (October 2015), ‘the average retirement portfolio… has just $136,200 in it.’ This severe shortfall has led this strong and capable generation to rely heavily on the promise of social security.

How they need to be reached and communicated to:

  • They still read newspapers and rely on the TV for their news.
  • They prefer face-to-face interactions over being buffered by forms of technology
  • They are happy to make due and while they have proven themselves to have a voice; they also believe in the greater good and tend to not want to make waves.
    • This tends to keep this generation a bit quieter than the millennial and more likely to ‘do as they’re told’.
  • They tend to have have more scattered families therefore are more likely to feel the need to maintain their independence and not have to rely on others for their well-being.
  • They tend to choose quality over quantity of life as they saw the harm done to their own psyche as well as the well-being of their parents due to the options and institutionalization of the end of life (noted above).
  • They are not quite as adept at researching their options and tend to lean on others who are ‘at the helm’ be it in commerce or healthcare. They want to be involved in decisions which keep them healthy and capable but are overwhelmed by the vast amount of information available to them.
  • Offer a support team to help in major healthcare decisions and the ability to decide how they’d like to proceed.


Born approximately between the years of 1982-2004, Millenials are between the ages of 12-34 years. There is a great discrepancy on the range for this generation but for the sake of defining the borders of the generation we’ll ascribe to the categorization as set by Strauss and Howe. They were born during a time of connectivity. The internet was growing…exponentially. The Berlin Wall came down, unifying Germany and offering hope to the world.

While born into a time of unification it was also one of great uncertainty and lack of control of ‘others.’ There were bombings (Olympic Park, Unibomber, 911), and the OJ Simpson’s highly televised ‘chase’ and trial brought a new level of ‘reality TV’ into our homes. Drama was everywhere and now instantly accessible 24 hours a day. AIDS was an epidemic, and school shootings began, starting with the Columbine High Shooting, and continued.

This generation of Americans are technologically versed and fragmented. This was truly the MTV Generation; they never knew a world without music on TV.
The internet was accessible – AOL (1985) and email became a part of their world. Many were never aware of a ‘before the internet’ timeframe. News came predominately from TV and the Web, with Newspapers taking a back seat.

This is a generation that is:
Connected – Millenials are always connected to others and by various devices. “Smart” devices (phones, watches, cars, appliances, etc.) are responsive—or work across platforms or other devices at once— and support the use of multiple use as they thirst for a connection to the world.

Multi-taskers – Due to the multitude of devices at their disposal along with managing their ‘off-line’ existence, they’ve become amazingly adept multi-taskers.

Involved and wanting to give feedback – This generation relies heavily on others who came before and also, a type of a trickle down effect, are more willing to give feedback to those who may follow. They feel their voice has value, and they want to share opinions. This generation was likely raised in a household where things often revolved around them unlike the generations prior which were not nearly as child-centric. The generation proceeding them, Generation X,  was full of ‘latch-key’ kids so the parents for this generation tended to over compensated for this one. I believe the benefit of this is a stronger more confident voice for this generation which is in direct dispute with the other option and misnomer, the ‘Me Generation’.

Community oriented and ones who wish to effect change – As per the reasons above, they have a level of self-confidence not seen in past generations and with that a belief that they truly can change things. Consequently, there is a willingness to try to find opportunities to succeed often in niche ways (entrepreneurial) not seen possibly since our Greatest Generation (Those who grew up during the depression, fought in WWII and went on to build what is ‘modern-day’ America).

Comfortable with self-expression – Again their level of self-confidence leads to their ability and willingness to express themselves how they see fit —whether it be body adornments such as tattoos or piercings or freer expressions of themselves sexually. This freedom extends to other behaviors and groups as well and affords them a higher level of acceptance for people of other faiths, ethnicities and race.  For them, all is permissible within the realm of being true to themselves.

How they need to be reached/communicated with:

  • Meet them on their terms, where and when they want and bring them into the discussion and decisions – Don’t talk to, or sell them.
  • Utilize many avenues of communication from internet/social media, tv and lastly print.
  • Prove how working with, buying from or partnering with you affords them the opportunity to effect change and make a better world.
  • It’s not aways about the bottom line financially for them as much as it is about where the rubber meets the road and what it means for the greater good.
  • Lead them through their options and allow them to mix and match things as they see best suits their needs be it on a purchase or their own well-being/healthcare.
  •  Incentivize them to give positive feedback so others, like them, will follow suit.


If you still aren’t sure how to cross the generational divide, the magazine Gold Digest offers some more specific advice on how to play golf with a boomer versus a millennial.