Evie was often referred to as the conscience of the Camlin Community Hospital (CCH).  She was a Registered Nurse who had been at Camlin for 42 years.  She set the standard for patient care.  CCH was looked upon as one of the best small hospitals in the state based upon patient ratings.  Evie had a lot to do with how patients were treated.  Although she had no administrative title or authority, she set the standard by how she cared for patients.  If someone didn’t meet her care standards, she would have an “Evie talk” with them.  This included medical doctors as well as other caregivers.  Woe be it should an administrator or staff member display an attitude toward patients.

Unfortunately, trends in medical care did not favor small community hospitals.  CCH was taken over by the state’s major hospital, which was affiliated with the state’s university.  The takeover quickly refocused the hospital from patient care to bottom line concerns.  Evie decided it was time to retire.  A lot of the medical doctors she “trained” also retired.  They were replaced by travelling physicians from the acquiring hospital.  A number of these physicians had limited abilities when it came to bedside manner.  Since they held faculty positions at the university, they had dual roles in clinical research and patient care.  Bedside manner was not how they were evaluated.

The standards of care for which CCH was known quickly evaporated.  While Camlin’s residents had little choice about where to seek medical care, CCH developed a terrible reputation.  The pride of Camlin in its health care system was gone.  Community pride is very fragile, and the loss of pride in CCH quickly spilled over to other parts of the community.

What CCH experienced is called anomie.  As originally envisioned, anomie refers to a societal culture which lacks a set of shared values.  There is no standard for what is right and just.  Leaders are not role models of what people should expect of their fellow citizens.  A moral compass no longer exists.  Individuals only care for what is best for them.

Anomie also applies to private sector organizations as well.  Every organization has its own culture.  Surprisingly, this culture is often more bottom-up driven than top-down.  There are Evies in every organization where a strong culture exists.  One person can set the tone for organizational norms just as Evie did.

One reason that corporate margins and acquisitions often fail is that they don’t appreciate the culture legacy that has been forged over many years.  That legacy doesn’t appear in any due diligence documents.  It’s not hard to identify, but it can be very fragile to preserve.

While cultural pioneers must eventually retire, their legacy doesn’t have to retire with them.  But unfortunately, the legacy they leave is often not valued by those in leadership positions.  The result is anomie.


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