LANDING THE RIGHT JOB isn’t just about matching your experience and skills to the best opportunity. How do you ensure that a workplace’s culture is your cup of tea, too? That is, will you be able to practice medicine the way you want, with people who share your values and priorities, in a place that supports your growth?

Hospitals and organizational culture aren’t typically all good or all bad. Some places may just be a better fit to your personality than others. But there are a few things you should know in achieving a quality match.

Defining culture

So, what is workplace culture? When it comes to an organization, it’s often described as the purpose and personality of the place, shaped by its core values and reflected in people who exhibit them. The entity courting you may have a vision or mission statement touting “what’s important to us.” But the bigger cultural piece is what the leaders and others do to back up their words. Who do they hire? Where do they put their money and efforts? What’s the underlying or shared mindset?

“Don’t put much emphasis on what people say,” says Kip Aitken, director of physician recruiting at CGh Medical Center. “Do put an emphasis on how people act.”

It was the culture of Physicians’ Medical Center, PC, that recently drew Caleb Hentges, D.O., to the primary care clinic where he’s a pediatrician in McMinville, Oregon. His team leaders not only share his philosophy of medicine, but “are more than happy” to encourage him beyond delivering quality care. That includes pursuing any number of opportunities, vis-à-vis the American Osteopathic Association, to become a medical leader, advocate, and even change agent.

But most of all, Hentges collaborates with a mix of physicians, nurse practitioners and physician assistants who not only work hard, but also have fun while doing it. “They keep things upbeat and light,” he says. “You can tell that everyone is driven not just to take care of their patients, but to do so in the best possible way so that they achieve the best possible health outcomes.”

Why culture counts

You’ll likely spend—statistically speaking—more of your waking hours with your colleagues than family. That’s a great reason to aim to be surrounded by people with shared goals and like-minded attitudes, especially since such commonalities can have a positive domino effect.

Since the philosophy of a practice ties into its culture—and the culture is a large part of career satisfaction— being generally aligned with your coworkers is key. “Physicians don’t provide medicine in a vacuum,” says Jessica Lewis McCrary, physician recruiter for ETS OBGYN. “It’s critical that culture is a match so that they can all work at their peak.”

Indeed, if your values, expectations or priorities aren’t in sync with those of the organization, you may not find practicing medicine meaningful or even conducive to producing great outcomes. Instead, you’re at risk not just for early burnout, but also a myriad of frustrations and other manifestations tied to being a very unhappy camper.

Robert W. Carr, M.D., MPH, an executive coach and start-up consultant, refers to it as cognitive dissonance, the kind of discomfort that occurs, in this case, when your standards and styles are in conflict with those of your medical colleagues. That disconnect can create underlying tensions or subconscious stress, triggered and exacerbated by your day-to-day workplace activities. “You need to be in sync with certain aspects of those core values and expectations,” Carr says. “When you’re not, you’ll have that distress.”

Indeed, you’re likely not only in for a rough ride, but your tenure in the job may also be at stake. Will it be long-lasting or short-lived? Since culture represents those built-in belief systems that make up the fabric of the place, it’s non-negotiable. You may be able to tweak things, but you likely can’t change it completely to fit you. So if it isn’t a match or you can’t assimilate, you may have to search for true soulmates elsewhere.

Lifepoint Health’s Kelly Cottrell recalls being super excited to recruit a partner for a universally beloved physician. But things went south quickly after the new hire—a detail person—discovered that his engineering mindset just didn’t jive with the big-picture provider who wasn’t great with the mechanics of running a practice.

Although both physicians wanted to provide quality care to their patients, their organizational styles were so different that only a personality change — in one or both — would have saved a doomed partnership. Obviously, better soul- searching beforehand could have nixed a horrible fit. By simply asking “What would drive me nuts?” says Cottrell, “they would have ruled each other out pretty much immediately.”

Granted, differences aren’t always a relationship-ending slam dunk. Even the best physicians can disagree in their way of doing things, either clinically or in other areas. When presented with the same diagnosis, for instance, you may recommend one approach while your colleague takes another. Both may be perfectly appropriate for the patient. But if the disparities are so pervasive that you can’t function in the way you want to function, they could short-circuit your tenure and hasten a new search.

Finding your place

So how do you identify a practice or group that fits your values and style? For starters, preparation is indeed good for the soul. To avoid joining the wrong culture, it’s imperative to define the right one. What do you need to be in sync, not just with the job, but with your workplace colleagues and the culture?

Obviously, nothing replaces old- fashioned soul-searching. But you also need to have your research ducks—and questions—in a row.

Whatever you learn will help you not only craft your questions but, with a curious eye, evaluate what you hear, see or experience on the ground. How does that intel compare with the organization’s stated mission, vision and values? More specifically, how do you want things done and what do you need from your coworkers to be in sync with them?

“When I talk to physicians, I really drill down on that theme,” says Candace Ash, physician recruiter for CommonSpirit. “I encourage them to consider how they want to practice and base their questions on that. They need to understand if they’re in clinical alignment with the group.”

Indeed, with research in tow, you should be ready to drill down on those specifics that help you find that alignment. For starters, you want to get beyond those cookie-cutter inquiries that often come to mind in an interview. Why is this position open? Do you have any concerns about my application? What are the next steps in the hiring process? Instead, focus on topics related directly to the culture: What does the support structure look like? Is there a defined mentoring program? Why do people enjoy working here? What would they change?

A good strategy is to use the same behavioral, situational or “round robin” techniques that bosses like to use to measure how candidates work: Tell us about a time when you did such and so. Or: Tell us about your experience doing this or that.

Don’t be shy in asking: Can you describe an initiative or even an unpopular decision in achieving your vision of diversity? How are people valued here? How do you show them?

McCrary notes that if someone remarks that the organization is patient-centered and team-oriented, with good work/life balance to boot, don’t just settle for generics. Since the comments can mean different things, go for specifics: What do you do to provide patient-centered care? How does the team work together? How do physicians here attain a good work/life balance? Can you give me examples?

“When you’re evaluating a culture, you have to pick out these nuances,” McCrary says, “and compare them to what will be a good fit for your personality and goals.” 

During your on-site interview, you’ll want to talk to anybody who will be part of your orbit for their unique perspectives. By snagging lunch or dinner with potential future colleagues, you may net a valuable cache of off- the-cuff comments that are either a cautionary tale or a green light for joining the group.

As Donna Shelby, director of physician recruitment for Citizens Memorial Hospital in Bolivar, Missouri, notes: “That’s where you get the true picture to support that gut feeling that you get when you’re on-site.” Lisa K. Cannada, M.D., trauma surgeon with Novant Health Orthopedic Fracture Clinic, agrees, noting: “You need to be there among the people. That’s when they’ll let their guard down and talk.”

For instance, how would they describe the leadership or decision-making structure? Is this a rigid hierarchy with new physician hires being low on the totem pole? Or is it less rigid with collaboration and few rules ruling the day?

Obviously, you can pose those questions to the leaders themselves. But if you
have the opportunity, you want to hear what others might think of the people they answer to daily. It can make a difference, for instance, if your future bosses come across as arrogant or even authoritarian versus kind, giving and caring.

Heather Furnas, M.D., co-founder of Plastic Surgery Associates and Allegro MedSpa in Santa Rosa, California, notes that it all carries through. “Patients will pick up on it,” she says.

Whatever you hear, don’t hesitate to broaden your informational net to include anyone — nurses, nurse practitioners, physician assistants or even business types — who’ll be supporting you in doing what you need to do.

Whatever your specialty, don’t be afraid to repeat the questions you’ve posed previously to any team members or leaders. You want to determine if the responses are contradictory or in sync. “You just want to be as open and probing as you can,” Carr says, “because you’re really trying to get a feel that this is going to be the fit that you need.”

Finally, when it comes to practicing your specialty, culture can mean the difference between having or not having what you need professionally. Obviously, it’s a plus if your new employer will help you develop your present skills or add new ones to an already robust CV.

But what about resources? If a certain piece of equipment, for instance, is key to your patient care, will your bosses move mountains to get it? You may be joining an organization where no individual scores everything he or she wants. Then again, maybe you’re lucky, and the leaders are willing and able to remove any barriers to your request. If not, however, you at least understand how and why the decision was made.

If you’re joining an entrepreneurial practice, you should be interested in any particulars suggesting its stability and/or growth. As both a med-spa owner and author of The Business of Plastic Surgery, Second Edition, Furnas advises physicians pursuing similar practices to look at the books. Granted, no one’s going to share specifics during an initial interview. But when an offer is close, it’s time to open the ledger. “If they don’t want to show you their numbers, that’s a red flag,” she says. “But if you’re serious, you want to know if they’re paying a ton of overhead or even ignoring profligate spenders. You want to look at every potential nuance you can pick up.”

Final thoughts

Obviously, you’ll have many factors beyond statistics to consider in finding a culture that matches your patient care and work goals.

But in the end, it may be personal attitudes and policies that really grab your attention and sway you. In short, you want to know how your future colleagues respond if any number of life’s emergencies and issues put your productivity at risk. Besides hearing that the organization offers family leave, for instance, what occurs when a colleague faces a health or other crisis? Is it still only about work?

For example, after she interviewed for her current employer, Cannada had two weeks to let her bosses know if she’d accept their offer. Once they heard, however, that her father, a fellow physician, had just passed away, they not only sent flowers, but told her to take as much time as she needed. Indeed, since life can change in an instant, you want a sense of what that might mean to your colleagues and you!

As Cannada notes: “That’s going to tell you about the culture.” •