Treat Culture Like A System

business business culture business health business structure fix this next fix this next for healthcare providers group practice healthcare hierarchy of needs order order level systemize systems vital need May 20, 2021

| By Tara Vossenkemper, PhD

I’ve only worked a handful of jobs in my life. When I started at the restaurant, I was hired on the spot. It was a new store opening. I remember walking into the restaurant as it was gearing up for the grand opening and meeting a woman named Kim, the manager. I loved her. She obviously loved me, too, because she hired me on the spot. No assessments, no interviews, no formal anything.

I was terrified, for the record. I had never worked in a restaurant before and I didn’t really ‘get’ the flow of things. I’m a person who learns quickly, but only when I’m actively doing the thing I’m trying to learn. We spent a lot of time training during the couple of weeks leading up to the opening, but it took a few weeks of being fully immersed in serving before things really made sense for me. Ugh, gawd, and it also took a few humiliating mistakes before I got it. Think spilling a whole tray of drinks on one guy at a booth… yeah.

One other example of my earlier ineptitude is that I didn’t realize that ordering food should be done after the appetizer hits the table. This was during our soft launch and I had never had an appetizer ordered with other live tables and at the same time as the food was ordered. I even remember having the question, “I wonder how the kitchen will know how to time things. That’s pretty cool they have it figured out.” Ha! They didn’t. I just didn’t have a clear sense of my part in the process. Kim reiterated the process and expressed understanding, also sharing a similar mistake that she made earlier on.

That was the ‘vibe’ at that time. It was warm, supportive, and overall positive. People were excited to be there, they genuinely liked each other (mostly), and everybody had a clear-cut mission. I loved being there. 

Culture Isn’t Static.

Over time, things began to change. I didn't realize it was happening, but it happened. Slowly, the original folks left. Slowly, management evolved. Kim left (the manager I loved). The newness and excitement and focus on being exactly on-brand began to shift. Worst of all, people stopped being supportive and started being more critical of each other, as well as less intentional with the processes that were in place.

After that, it was as if the blinds were opened and I couldn’t not see the sheer amount of overall indifference and lack of follow-through. The focus on me and my, rather than us and team. There was an erosion of duties and a shift to social loafing. It was very disheartening.

People tend to think of workplace culture as a static entity. It’s like there’s an immediate influx of information about “culture” and “values,” and then it stops there. As in, there’s some sort of training so that people can memorize what those things are, but there isn’t any follow-through on them. There isn’t a consistent and ongoing negotiation process and grappling with said values in order to let them evolve. It’s treated as static.

But culture isn’t static.

It’s evolving. It’s malleable. It’s constantly changing and mutating and shifting to reflect the fullest version of what’s happening within any organization at the time it’s occurring. 

When we bring on folks who naturally fit within the culture, it makes life easier in that the culture can mostly maintain. Any shifts might seem small because we have people there who have those natural inclinations that align with the larger body. Think a drop of pink in a bucket of red. Maybe not exactly the same, but a very close fit and one that you wouldn’t really be able to notice. 

With new hires, it’s easy to say, “this is who we are, this is what we do.” But what if there isn’t follow-through of some sort? What if there aren’t ongoing conversations about the values, about the expectations, about the “vibe?” 

Culture Is Order

When we boil it down to the simplest form, culture is order.

Wait, first of all, let’s talk order. Order is the third level of the Healthcare Hierarchy of Needs. This is the level that’s all about making your systems and processes more efficient, automating our processes, and streamlining. I’d also add that it’s where we create and implement systems that we need for a successful business. Order is systems, my friends. And yes, culture fits there.

Now, here’s my posit.

Culture is as much a system within a business as any other system that currently exists, including the seemingly super cut-and-dry systems like billing or front office. Culture is a system. Not only is it a living, breathing, malleable system (think Bronfenbrenner and his ecological systems theory), but it can also be treated as an intentional, thoughtful series of processes that we implement to ensure the system (read: culture) stays healthy. And if you think this doesn’t matter, do a quick search on “workplace culture and profitability.” I’ll wait.

SEE?! Culture is so important. AND it directly impacts our profit. 

So, here’s where we are:

  1. We know that culture is important.
  2. Culture should be viewed and treated like a system that fits within the order level of the Healthcare Hierarchy of Needs.
  3. We need to implement a variety of processes that support the cultivation, fostering, and continued development of a healthy culture.

I think that most of us appreciate and prefer being in a healthy culture. That’s probably a given. I also think that we don’t tend to think of culture as intentional, and thus we fall prey to it evolving without any intentional input. It can shift towards unhealthy and we focus on ‘fixing’ other systems without thinking about the need to fix the culture. My point is that bad cultures aren’t only a result of shitty bosses, poor leadership, and evil-doers. I imagine that they’re unintentional and often accidental.

That doesn’t make them okay and that doesn’t absolve us of our responsibility.

Systemize Your Culture

Let me wrap this up. I want you to have something, even a little something, that you can walk away with regarding culture as a system. Here are three simple, easy, effective ways to start treating culture like a system.

(I’ll also forewarn you that Gino Wick does way more detailed explanations in his book, Traction. I take little to no responsibility for these specific moves, but I’ll talk about them until I’m blue in the face.)

  • Identify Core Values
    This might seem like an obvious statement, but it’s a must. Consider your core values like your baseline. You can’t assess the current state, you can’t clearly articulate the culture for folks coming in, you can’t make future decisions with any sort of confidence (regarding culture) without them. Core values are a must. And you should not get these done in an hour. Review them annually as a process.  
  • Embed Core Values Into Hiring
    Embed your core values into your hiring process. These should be part of what you do when you bring folks on to work with and for you. Make sure they know how significant these are to you, to the team, and to their employment. Ask for an honest personal assessment, but also set up situations or questions where you’re getting at the core values without directly asking about them. Hiring is a process and culture needs to be part of it.
  • Talk About Core Values Incessantly
    Don’t set them and leave them. Talk about them. In meetings, when you’re giving feedback, when you’re thinking out loud about the future of your business. Talk about them. Think about them. Live them. Again, you can formalize the process of talking about them and embed them into your business. That’s where the order comes into play. They’re not set and left. They’re intentional and living. 

I hope I have you convinced. Culture can be such a vibrant, positive thing for a business. I know we all have a parallel to my restaurant experience. Where it started out amazing, took a slow and gradual decline, and then nosedived off the cliff into toxic and shitty. I hated that so much. It felt like a loss. I feel more compassion and understanding about it all at this point, but it wasn’t something I loved going through, and it’s not something I want people to go through if it can be helped.

Your takeaway: treat culture as a system and embed that shit into your business. 


Tara Vossenkemper, PhD, is the founder and owner of The Counseling Hub, an accidental group counseling practice in Columbia, Mo. Tara has since stepped into consulting in a more serious capacity, setting out to ensure that practice owners know both what they need to do and how to do it. Tara's favorite consulting-related topics center around tracking, culture, structure, and diagnosing core issues.

Tara is known for her colorful language (#PuttingItNicely), love of The Office (#USVersion), neuroticism around dashboards (#FormulasAreLife), and hashtags (#AllDay). When she's not in the office, Tara can be found hanging out with her husband and two young sons, probably drinking a glass of red and wishing it was quiet enough to read.

Check out Tara’s professional bio and her practice, The Counseling Hub

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