Ingrid M. Nembhard, Ph.D., M.S., Sara J. Singer, Ph.D., M.B.A., Stephen M. Shortell, Ph.D., M.P.H., M.B.A., Diane Rittenhouse, M.D., M.P.H., and Lawrence P. Casalino, M.D., Ph.D.
I. M. Nembhard, S. J. Singer, S. M. Shortell et al., "The Cultural Complexity of Medical Groups," Health Care Management Review, July–Sept. 2012 37(3):200–13.
To adapt to new models of care, like the patient-centered medical home, some medical groups will need to alter their practice culture to make it more collaborative and patient-centered. Such a transformation requires an understanding of the different types of cultures that are present in physician groups and how those varying cultures influence performance.
Commonwealth Fund–supported researchers studied eight multispecialty medical practices, looking for evidence of seven culture types: group, which emphasizes teamwork and strong staff relationships; hierarchical, which values stability through adherence to rules, policies, and procedures; rational, which prioritizes productivity, efficiency, and achievement; developmental, which stresses growth, change, and flexibility; quality-oriented, which focuses on evidence-based care; patient-centered, which emphasizes responsiveness to patient preferences; and physician-centered, which seeks to preserve physician preferences and authority over clinical decisions.
The researchers found that:
The researchers conclude that it is important for managers is to assess the culture types present in their groups and examine whether those cultures are consistent with the groups' goals.