Those aligned with the tangible culture like to work with people they can see and “touch” (tangible) and work in relationships that are long-term and grounded in reality (tangible). There is nothing better than seeing their patients mature over the years or of honoring a fellow employee for their 30 years of service in the local hospital. Leaders who are aligned with this culture also are inclined to turn for guidance to others in their system who focus on deeply embedded patterns (traditions) in the organization. Cultural change is either considered impossible or unwise. A strong emphasis is placed on the full appreciation of existing and often long-standing dynamics of the organization—this emphasis being most fully articulated by those embracing an “appreciative approach” to leadership (Shrivasta, Cooperrider & Associates, 1990; Bergquist, 2003; Cooperrider and Whitney, 2005).
If one is oriented toward the tangible culture. then they are likely to be concerned about the desire of their patient (or fellow worker) to interact via a phone of mobile device. The patient or fellow worker might declare that they have “no time” for an in-person meeting. A health care worker who is inclined toward the tangible culture doesn’t feel like they really “know” this person and would much prefer to meet in person for at least a short period of time. Much more could be accomplished. As a physician or administrator, she would be much more comfortable in picking up subtle clues at a later time when interacting by phone or mobile device. If she at least has an opportunity to work with her patient/co-workers in person once in a while, then she can more effectively interact with them virtually.
Health care leaders associated with this culture embrace many untested assumptions not only about the value of personal relationships, but also about the ability of organizations to “weather the storm” of faddish change. They conceive of the developmental enterprise in their health care system as primarily the honoring and reintegration of learning from existing sources of distinctive wisdom located in their specific organization. These leaders tend to be appreciative, loyal (and sometime a bit narrow-minded and resistant to new ideas): “the new technology is fine—but let’s remember what really heals people and how organizations really navigate the turbulent waters of contemporary health care!”
Given the postmodern challenges facing contemporary health care leaders, it is obvious that the tangible coach is potentially of great value—for leaders long for reassuring strategies that are directly aligned with the tangible culture. They want to be able to meet with other people face-to-face; they seek out a time and space that is safe. When effective, the leader and health care provider who is aligned with the tangible culture will help create a “sanctuary” in which her patient can talk about anything and feel deeply. This patient may have no specific agenda, nor does he necessarily want to change his health-related habits. He mostly wants to find a safe place where he can “be himself,” “talk to someone who holds no agenda other than being there for him,” or “simply be listened to by someone who cares about his personal welfare.”
These tangible needs are aligned with a holistic perspective regarding health care. They are not easily captured in a formal statement regarding the health care workers responsibilities. However, as in the case of the alternative culture, the strategies associated with the tangible culture may be immediately effective in helping to create (or sustain existing) patterns of meaning and reduce postmodern anxiety. Unfortunately, this type of health care service is often reserved only for those with sufficient power, wealth or opportunity to meet over an extended period of time or to meet frequently with their health care provider. Thus, the tangible culture – more than any of the other five cultures – is often associated with health care services that are reserved for the elite.
