New Providers: Why Organizational Culture Matters
The culture of an organization — its values, beliefs, and assumptions — has a significant impact on our happiness, success, and career longevity.
In today’s post, I’ll share my experiences practicing medicine at three very different organizations. I’ll also discuss why finding a workplace whose culture aligns with your values and priorities is critical to your long-term happiness and success.
I didn’t always want to become a physician. Growing up, I thought I’d follow in my father’s footsteps and become a lawyer. But my dad encouraged me to pursue the more “noble” profession of medicine. By the time I got to college, I was speeding along the pre-med track.
During my internal medicine residency, I had a strong feeling that my calling was in outpatient medicine. But when I finished residency in 2009, the country was in the midst of a massive economic downturn, so I just wanted to get a job somewhere. I joined a hospitalist group in Fresno, Calif., practicing inpatient medicine. I enjoyed many aspects of that first role, especially challenging cases, friendly colleagues, and a flexible schedule.
We had pretty good benefits and received our paycheck every two weeks. But as employed physicians, many of us didn’t feel truly invested in the success of our group or hospital. And after a few years, I was ready to pursue leadership opportunities, but the organization lacked a formal pathway for professional growth.
Making the Move From Inpatient to Outpatient Medicine
After almost five years with the hospitalist group, an outpatient opportunity came up with a large integrated medical group that follows a managed care model. I had wanted to practice outpatient medicine since residency, so I jumped at the opportunity.
What happened? After about a year in the job, I was very unhappy. I discovered that I didn’t enjoy outpatient medicine after all. Nor was the organization a good fit for me. The patient workload was intense, as we were expected to see a high number of patients per day while being thorough, yet quick.
In my role, I also had very little medical decision-making autonomy. When I tried to start a medication or prescribe a course of treatment, I was faced with authorizations and required to run my recommendations by specialists for approval. "Wait a minute," I thought. "I’m a physician too. Why do I need this much oversight?"
The other challenge for me was that I didn’t see a path for advancement, as many of the physician leaders had been in their roles for years.
I realized after about a year that this wasn’t the place I wanted to spend the rest of my career. With physician burnout at an all-time high, I knew I needed to make a change. So I decided to go back to hospital medicine.
I talked with a couple of former colleagues from my old hospitalist group and found that they had joined Vituity a couple of years earlier. They all emphasized that Vituity, with its Partnership model, was a totally different experience. They said it was difficult to explain, but assured me that once I’d been there for a few months, I’d understand what they were talking about.
What did I have to lose?
From Employed Physician to Partner
I joined Vituity two years ago, initially working at Adventist Medical Centers in Hanford and Selma, located in the Fresno area. Later, I also began covering a third hospital, Saint Agnes Medical Center. I loved the variety of practicing at different locations. And as a Vituity Partner from my first day on the job, I felt the difference in culture immediately.
I now felt valued for my expertise and felt a strong sense of ownership in my hospitals. I finally have the local decision-making autonomy I’ve been missing. At the same time, I have the support of Vituity’s physician leaders when questions or issues arise, as well as access to proven clinical and administrative programs.
Because we’re all equal Partners in a democratic group, everyone is very motivated to make a positive contribution. If there’s an initiative underway, whether it’s improving patient satisfaction or throughput metrics, there’s a high level of collaboration and teamwork to achieve those goals. Because the hospital’s success is our success.
Two years into my career with Vituity, I see a clear roadmap for professional growth within the organization and at my hospital sites. I’m currently chair over the Morbidity and Mortality Committee for the Adventist Medical Centers at Selma, Hanford, and Reedley. For Vituity, I’m part of the Clinical Education Committee, helping to organize symposiums and conferences. My goal in the next couple of years is to take on more leadership roles, like a medical directorship.
I think it's important to acknowledge that no practice setting, including Vituity, is perfect. But with so many avenues to grow and flourish as a physician, I definitely see Vituity as a great place to develop my career over the long-term.