From Dr. Keith Menard – Reflections on Culture

Originally appearing as a submission in the Island Health newsletter

Dear colleagues,

I want to ask for a few minutes of your time to pass on a story and ask you to do something special this week; something that only takes a few minutes but could have immeasurable impact. My wife, who generally has kind things to say about me, often suggests to others that nothing seems to scare me. Clearly this is not true. Perhaps it would be more correct to say that she just doesn’t know what scares me.

One thing that scares me more than anything, almost to the point of causing me nightmares, is to find myself come face-to-face with one of the many people I work with each day, someone I’ve known for many years, and have to admit during a feeble and awkward attempt to introduce them that I don’t know their name. And should such event ever happen in my wife’s presence (“Honey this is, oh, who are you again?”) I would be even more horrified that what it really implies is not just a slip of the mind, but that I probably have never bothered to find out anything about this person. This is something my wife would be most disappointed to think (she has probably never forgotten a name in her life).

There’s more to my fears than forgetting names and being embarrassed in front of my wife. Forgetting about people and forgetting our humility is my real concern. For our success as “healers”, we rely on a large and complex team. This includes nurses, unit clerks, lab technicians, diagnostic imaging staff, cleaning staff, social workers, therapists… and the list goes on! Doctors no longer work in isolation in our increasingly complex medical system. We depend on this team, and they depend on us.

A few years ago, I read the story of a famous CEO who would interview prospective employees by taking them to his favorite restaurant. Unbeknownst to them, he would arrange for the serving staff to mix up the candidate’s order. His purpose: To see how the candidate would treat the serving staff. This CEO knew that creating a positive and productive work environment meant hiring people who respected and cared for all of those around them, not just those they report to or could personally benefit from.

Reflecting on this story, I could see one of our classic mantras appear before me: Primum non nocere – first do no harm. As physicians, we work hard, day after day, to help others. This is our purpose. Sometimes we succeed, sometimes we fail. We do this work in a very stressful environment with all of the additional pressures each day; services constraints, nursing shortages and electronic medical records, just to name a few! Regardless, at the end of the day we hope that we have made the world a little bit better, and if nothing more, at least we have not made it worse.

Lately there has been a lot of talk about one word: Culture. Yes, a grossly overused and abused term, but what does it mean to us? I think our culture is more than just “the way we do things around here”. Our culture is the very essence of how we interact with our team, how we treat each other, and how much we care about one another. If we mistreat others, if we ignore or take for granted the efforts of our teammates, no matter what their role is, we unwittingly break an important part of our commitment to do no harm and contribute to the erosion of our culture.

This week is not “be kind to your colleagues” week, or “bring your MOA flowers” week, but I would like to ask each of you who has read this to do one thing this week: Think of someone you work with, who you see every day but have never really spoken with. This may be the person you always smile at, or nod to, but you don’t even know their name. Maybe you don’t even know what they do. Next time you meet them stop. Say a real hello. Ask them about themselves. Not only will you learn their name, you will also learn something about them and foster a connection that improves our culture.

We don’t need committees or consultants to explain to us what it means to work well together. What we need is more caring and more understanding. When we lose this essence, we lose the engagement of our team, and when we no longer work as a team we cannot succeed. We can create positive change whenever we realize what is wrong and take steps to make things better.


Dr Keith Menard
Head, Department of Maternity Care and Pediatrics
Island Health

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