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Culture and Subculture

Health wise is a not-for-profit international provider of online health information and tools (it is, for example, a content provider for WebMD), founded over 35 years ago by Don Kemper, who remains CEO. Building and sustaining a culture focused on respect, inclusiveness, and transparency has been a hallmark of the organization since its beginning. It continues to be crucial to the six-person executive team, which spends at least two hours a month discussing the organization's culture and how to preserve and nurture it even as the organization changes. Some key elements of the culture involve a focus on getting the job done, not just "spending time," which provides flexibility in work hours and location for employees. Transparency of information encourages (perhaps more than some would like) frequent meetings to ensure that everyone who needs to understands key issues. The culture is constantly discussed within the organization and modeled by managers. When deviations from it emerge, people take the time to talk about how or whether certain actions enhance or hurt the culture.

Job applicants (and aspirants who wish to apply for a job someday) mention its culture as a major attraction. Senior managers say that depending on the position, the organization routinely receives 50-500 applications. In 2010, for example, 120 people applied within 24 hours for a receptionist. For all jobs, the interview/recruitment process is extensive, comprehensive, and grueling for both recruiters and applicants. For those who pass the initial screening, there is a phone interview followed by a day of in-person interviews with three to four people in the functional job area. The next step consists of a full day of interviews with 10-12 individuals at all levels and several areas of the organization. If the applicant makes it through this stage in the process, the final stage involves a case study or assignment that replicates job tasks. The process itself conveys much about what the organization's members consider important, and in particular, the criticality of finding people who fit the organization's culture. The success rate is high, and turnover consists mainly of employees who retire or move from the area. Rarely do people leave for other reasons.

Nevertheless, as the organization grew beyond a tipping point of about 150 people,77 the CEO sensed changes, and the semiannual survey of employees revealed that several mentioned a "decline" in the Healthwise culture. As Kemper investigated further, he realized that teams were developing their own (sub)cultures and employees were understandably feeling closer to a "team culture" than to the culture of the organization as a whole. In response, organization leaders began to urge team managers to create subcultures that work for the teams, but with an understanding that these cultures should mesh with the organizational culture but not be dominated by it. Even more telling is the fact that when the surveys are done, there are typically several pages of handwritten comments, both positive and negative. To respond to the comments and to reinforce one of the key elements of the Healthwise culture, transparency, the executive team began holding regular "fireside chats" during the lunch period. During these chats, each executive with responsibility for an area that received a negative comment responded to the comments. Specifically, what would the organization do if action was possible, or if not, why was change not possible. Again, the process helps to reinforce values of respect, inclusiveness, and transparency and communicates that any question or issue is open for discussion. Employees may not always agree with decisions but they will know why managers make them.

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