Medical Culture (and others) in Decline – the real reason for attacks on pharmacy and other health modalities.

We have been witnessing some extraordinary behaviour by the leaders of the medical profession (AMA, RACGP) that might make you wonder what hallucinogen they may have been taking, given the extreme claims of pharmacy creating a turf war, and their ridiculous claims of highly-trained pharmacists lacking skills to perform at different levels.
They act panic-stricken and seem to feel that they are being disrupted by pharmacists legitimately seeking to expand their “core business” through the development of professional services that fill an unmet need among the patient population at large.
They also behave in a paranoid fashion towards other health modalities, particularly the natural health variety, because they believe these modalities are soaking up Medicare payments or subsidies that are rightfully “theirs” and so lobby for reviews stacked with Skeptic extremists to prove these modalities are unworthy recipients of government funding.

Sounds more like a profession in crisis than one which claims to have legitimacy as a peak leader among health professions.
They are definitely not presenting as a calm and confident health profession – confident in their own skills and abilities, impervious to any intrusions through the boundaries of a strong, intelligent and relevant culture.
Quite the opposite in fact – and they know it!
Hence, the defensive and aggressive behaviours.
And with the rate of attrition they envisage coupled with poor leadership, just who will be left, or even want to be, a follower.

The fact is that the medical profession, through lack of an updated and embracing culture have succeeded in isolating themselves from a patient cohort that find themselves better treated in other health modality environments.
Despite the fact that the medical profession is given a legal gateway status for the provision and management of certain monopoly health service delivery, and for classes of medication supply, they are stuffing up all that they come in contact with.
And one classic example of a gap in medical culture is their attitude to medical cannabis.
Blow the thousands of patients suffering chronic illness who could benefit.
Just hold back the tide by waiting for their pharma ”mates” to patent synthetic toxic  versions or GM plant versions for an inflated price that they may eventually share in.

Unused to competition, doctors use political lobby pressure to dishonestly disrupt others (such as pharmacists) who then have to waste time and develop tactics to defend themselves.
It is difficult to collaborate in this type of climate, but coalface professionalism will win the day because it will be directed for patient benefit – not for the “hip-pocket”.
Medical leadership organisations are causing their members to become anxious about everything because they feel or have a perception of being disrupted and they, in turn, simply “lash out”.
The fact is we are all (in health and non-health organisations) experiencing the side effects of culture deficiency, but most of us seek to find solutions in positive change and cultural improvement to generate a permanent adaptable change for the better.
We do not badger others, use insulting behaviours or name-call like bullies in a schoolyard!
 One of the most serious problems relating to medical culture is that it is influenced by the globalist policies generated by international drug companies and their close association with the medical profession.
This finds the medical profession having to defend immoral or dishonest claims through the use of a policy of “scientism” rather than that of genuine science, and berate all others who are not true scientism believers.
How could you when it is a flawed value?
The “first do no harm” value that supposedly underwrites medical culture is totally fractured when you visit the real-time site  and see the death and destruction resulting from mainstream drugs.
The enormity of this issue cannot be sustained and the profession of pharmacy must create higher levels of health literacy to help patients defend themselves to survive.
And yes, recommend safer alternatives where it is appropriate.

Independent research carried out through Deloitte Consulting has found that culture adaptation and readiness to manage future directions for most business organisations is deficient.
In a recent survey they conducted, it was found: “90% of respondents said that their business model is being disrupted by some form of digital disruptor; 70% of them also said I don’t have the right people in the company, I don’t have the right leaders, and I don’t have the right skills.”

If you are a pharmacy owner/leader or a senior manager, do you fully understand your culture and how it’s impacting your own and your organisation’s performance?
Are you managing a clear journey to effectively evolve your culture with a direct and sustainable impact on performance?
There aren’t many leaders that can confidently answer “yes” to those two questions.
But we can construct a new values list that can provide us with the strong culture needed to sustain our organisations to ethically deliver.
And some of the “old” values may still have validity.
Two suggestions follow to start a values list for any health provider rebuilding culture:
1. First, do no harm. (still valid)

2.The value of our lives (professional and private) is not determined by what we do for ourselves. The value of our lives is determined by what we do for others.

Why not go on from the above two values and complete your own values list?
Then see if you can move on to actually living your culture and lead others within your organisation to adopt your culture. 

Deloitte, in their cultural research came up with five observations that needed to be addressed by all organisations

1. Most organisations are being disrupted and culture has become a business imperative
Organisations have technology challenges in their products and services; we should reinvent them for the digital world..

Survey results identified: “90% of respondents said that their business model is being disrupted by some form of digital disruptor; 70% of them also said ‘I don’t have the right people in the company, I don’t have the right leaders, and I don’t have the right skills.”

We are especially aware of our culture when we need to adapt or change.
Our world is growing in complexity and its experiment in globalism has been shown to be a dismal failure. The need for rapid change and adaptation is clear, but most leaders don’t understand how culture is driving the behaviour they see in their organisation and the related outcomes.

2. Define a common language and measurement for culture and climate
We all view the subject of culture from our own perspective, and the word has nearly lost its meaning.
A common language for culture and its measurement needs to evolve because it gives people a way to organise their thoughts around the concept.

It is suggested that the language should focus on “behavioural norms” because even though they may be invisible, they are the most visible aspects of culture when you define it in terms of assumptions, beliefs, values and the like.
These norms or “unwritten rules” are completely overlooked in most assessments and change efforts.

Norms and expectations within an organisation are not necessarily driven by the mission, stated values, and what leaders say they want.
Day-to-day norms are instead driven by what people experience around them.
That includes what people experience in terms of structures, systems, technology (especially social aspects like job design), and the skills and qualities of others, including their managers.
In many cases, these aspects of the work climate (which are defined as “levers for change”) fail to communicate or support the desired constructive norms and expectations—instead, they drive defensive behaviours, both aggressive and passive. These aspects are seen commonly in medical environments and are an illustration of cultural deficiency.

So how do you begin to define a common language and measurement?
This brings us to the third insight.

3. Combine qualitative and quantitative assessment methods
The qualitative has to come up front:
What are you trying to do?
What problem are you trying to solve?
This is the simple tool of Value Analysis commonly employed by management consultants.
The quantitave follows in an appropriate format.

The advantage of the quantitative is you can deal with large numbers and compare them and look at trends over time.
For that purpose, the qualitative isn’t very helpful.
After quantitative analysis, we have to go back to the qualitative because a program of actually intervening in the organization is not going to fly out of the numbers.
The numbers will only tell you roughly where you have to work and the direction in which you have to go.
The steps of the intervention, what you’re actually going to do day-by-day, is going to be a qualitative process because that organisation will have all kinds of unique aspects that the quantitative doesn’t pick up.
Speed is important to leaders so they must always be encouraged to act on indicator numbers so that an intervention results that is appropriately evidence-based.

4. Leadership must get ahead of the curve and make bold decisions to evolve the culture
“Command and Control” models of business organisations are models where decisions are made at the top, leaving the people doing the work without a say in how things were done.
For many years most organisations have been working top-down, and people are just starting to realise, what if working top-down isn’t working?
So there are now models of service evolving that involve a move to self-management.
Even iconic culture companies realise culture is a dynamic thing that must evolve.
If you learn from their lead you will culture change before you are forced.
How are you intentionally evolving your culture to support your purpose and performance priorities?
What bold decisions have you made to engage members throughout your organization in that journey?
It is possible to preserve important cultural strengths while collectively engaging your organization to take the next major step.
There are no guarantees, but a collective journey is far better than standing still or trying to manage improvements through command and control.

5. Diversity and inclusion are important factors to make better decisions that support the business strategy
Leaders must make the bold decision to evolve the culture, but that doesn’t mean they make all the decisions about what that evolution will look like. Diversity and inclusion are critical..

 Ultimately this will not only help an organisation to leverage and drive all of the things about creative thinking, innovation, our professional services; it will allow management to make better decisions about everything–not just how staff are hired, but develop, promote, retain, and do succession planning.
And not just about how we talk to people about unconscious biases–but ultimately how we develop products and services – how we actually move ideas across lines of demarcation.”

To avoid disruptors we also need to be sure that we are managing and leveraging diversity and inclusion in ways that make sense for our organisation, for our enterprise, and we need to be sure that the things that we’re doing are actually connected to the long-term strategy of the organisation and that they’re driving clear and realistic results.
Consistent involvement and encouragement are critical for connecting all team members to the improvement journey and to make better decisions as a team.

Two important additional insights to tie it all together

It may be difficult for leaders to apply the insights above (and others) in ways that clearly deliver business results and, ultimately, evolve their culture. Thus, it’s important to understand two additional insights..

* Culture builds through shared learning and mutual experience.
It’s a group thing, so it’s critical to engage leadership and all team members on a common journey to accelerate learning and deliver results.

* Culture is transmitted through climate factors and behavioural norms.
The current culture is reinforced in countless ways leadership does not fully understand, so that’s why a thorough assessment and thoughtful improvement plan are needed.

To apply these insights, you should engage your organization in a common journey to evolve your culture AND climate in an integrated way that supports your purpose and performance priorities. Follow these general guidelines:

  1. Focus your efforts on specific problems or outcomes you need to improve. The focus on clear priorities (customer/patient experience, growth, quality, etc.) will allow you to facilitate improvements faster than general “culture plans” and the connection to performance is clear. The entire team will learn from the focused work together and those learnings will naturally be applied to other problems and targeted outcomes.
  2. Understand how culture and climate are impacting work on the priorities you select through a thorough qualitative and quantitative assessment. This isn’t a “quick and dirty” assessment, but a detailed plan to manage the shift in norms and underlying assumptions that are needed in your culture. You will also identify the climate factors (systems, structures, etc.) that are causing these cultural attributes to be so deeply entrenched.
  3. Make a bold decision to engage members of your organisation in a common journey to adjust current strategies and plans for the areas you target in number 1 above.
    Don’t create a separate culture plan. Adjust how you engage leadership and the broader organisation in improvement plans so you overcome major cultural obstacles and effectively leverage constructive aspects of your culture.
  4. Help leaders and managers at all levels understand how their behaviour is reinforcing the current culture. Top leaders must go first to learn about this impact and adjust their approach because the “shadow of a leader” is incredibly influential.
  5. Intentionally re-engage groups in meaningful ways at defined periods to adjust plans, accelerate results, and drive learning across the entire team.

I2P has researched and developed a Continuous Culture Change Management program for any pharmacy wishing to survive successfully into the future in a confident and stimulating manner- the opposite to what is occurring at this point in time.
Contact us if you are interested at

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