— Aimee Winston (@AimeeSPT) July 4, 2014
So, then. Here it is! Culture war is never a truly pleasant topic to discuss. Why? Well. Let's be honest. It IS war. Read more on some of my Martial Arts Musings here.
War is a conflict which requires strategy, tactics, grit, guile, and quite honestly -- guts. You need to want it bad enough before you start it.
But, why "war?" Why the conflict? Why animosity? Why fight?
"Why so serious?" -- The Joker.
First off, not all war is violent per se. Fighting for culture change in the workplace is a battle of wills. We see this similarly in politics, ideology, economics, and education... All. The. Time.
But, the real answer: If we don't (change... win this culture war), we won't survive.
A telling quote comes to mind:
"I am more afraid of our own mistakes than of our enemies' designs." - Pericles
I think this is the very state of much of the healthcare industry. Physical Therapy is no exception. Our worst enemy is within our own ranks. Spirits of insecurity, dogmatic habit, fear of the new, complacency, clock-in/clock-out, and meeting the minimal performance requirements from a human resource measure... such is our enemy. These are the cancerous cells which decay our professional body.
To be blatantly honest, the strategy is this:
Deny your enemy promotion, recognition, and regard.
The immediate tactic at hand:
Out-perform your enemy in number, in measure, and in favor.
But, what can be done... right now?!
1) Out populate. Trust me, I tried it the other way around once before -- not cool. Fighting an uphill battle is hollywood, but, it isn't really that effective. Plus, it can get demoralizing really quickly. However, by building forces to out populate the enemies of complacency and underperformance, you quickly highlight the enemy's deficiencies.
2) Take to management. Remember how you hated that teacher's pet in middle school? Well, guess what? That is the best way to position yourself against the enemy. How else do you think you're going to be able to move up into management without your boss' endorsement? The more your boss likes you and not the enemy, the more ground you gain.
3) Go into the workplace together. This is perhaps the BEST tactic - especially if the opportunity arises. Committing to working in the same place, organization, or corporation together while in school or as a new graduate is a powerful way of quickly overpowering the enemy by shear presence and number.
4) Sneak up from under. Everyone needs to start somewhere. Many times, it is by having the "clinical experts" of the group "mentor" you that you suddenly realize their strategy -- how they've retained power all this time. As a popular saying goes: "Keep your enemies closer."
5) Highlight the deficiencies of others by trumping the quality of your own. It can really be bad business trying to call out the deficiencies of others. Rather, commit yourself to unwavering excellence. Your performance WILL be recognized. By contrast, the underperforming enemy will stand out like a sore thumb. It is only a matter of time before management will be forced to take action.
6) Volunteer a LOT. The more you volunteer, the more you get to participate in new things, special projects, committees, action teams, etc. The more you do, the less opportunities the enemy has to leverage such activities to maintain status quo.
7) Go out of your way. There is a lot to be said about going the extra mile. Go! :)
8) Start making alliances. Be nice. Be kind. Be amicable. Make friends and start finding well positioned players who you can recruit as allies. This is particularly powerful in multidisciplinary environments, ESPECIALLY in hospitals. Can you spell: N-U-R-S-E-S?
9) Become visible. In the same vein of volunteering, becoming visible has more to do with catching the eye of upper level management. Get into situations where you can interact with hospital CEO's, regional directors, etc. Get to know them by name and number and visa versa. There's a psychological phenomenon known as "mere exposure" - by simply becoming exposed to their mental construct, they are more likely to favor you in following encounters.
10) Care more. When people care... when they REALLY care, EVERYONE knows it. Everyone respects it. Everyone appreciates it. And, everyone wants more of it. The enemy rarely cares about much more than themselves. Sure, they may have mastered the art of clinical this-and-that, customer service, flattery, political posturing, and long-term-presence. However, by the very fact they are still apathetic to progress, resistant to change, and hostile to being out-shined... really, they don't care about anything other than themselves. You must care more -- and you must care more than just about yourself.
Again, culture change IS war - it can be and will become an ugly conflict. It may even make for a "hostile work environment" ooooooooooooooooh. And, while in the workplace, while you are not necessarily trying to get people fired, you ARE trying to get the wrong people from becoming promoted - from out-positioning and out-leveraging the forces of constructive change.
What are some ideal battlegrounds? Hospitals! Home health companies and regionally controlled outpatient settings are also fair lands to fight upon.
What are some terrible battlegrounds? SNF's! Also, private practice - and I mean this as in trying to blitz someone else's practice to change it. "To that I say: 'Ha! And, no.'" -- Wreck-It Ralph. But seriously, these two areas are awful areas to try to start a culture change. Why? Because you actually have no control.
Good battlegrounds for culture change exist where the above strategy and tactics can take root and cause permanent change. Especially in a SNF environment where the majority of "therapy staff" are internally vendored or externally contracted, there is no actual grounds by where anything can take traction. This land was already lost by mere fact of how things operationally exist.
Remember: This time, it's war. If we don't win, we all lose.