In recent years, with the introduction of the Internet Revolution in all late 20th Century and early 21st Century societies, we have witnessed the emergence of a new culture in healthcare systems – and in virtually all sectors of society. Elsewhere (Bergquist and Brock, 2008; Bergquist and Pawlak, 2008) I have labeled this the Virtual Culture—with its primary characteristic being the boundary-shattering access of most people to information and relationships that are not constrained by either distance or time. In these publications, I have also suggested that another culture has emerged. The Tangible Culture serves as a counter to the Virtual Culture, much as the Alternative Culture serves in opposition to the Professional Culture, and the Advocacy Culture serves in opposition to the Managerial Culture. Each of these cultures has attracted physicians and has provided a platform for physicians to serve in new leadership roles.
Emergent Culture One: Virtual Culture
The Virtual Culture has produced the role of Virtual physician-leader. This person now serves as a leading proponent of digitalized medical records, computer-aided medical treatments, and (more recently) the use of Artificial Intelligence (AI) in all medical services. The Virtual world exists at a distance from the actual provision of medical services. As in the case of those operating in the Advocacy and Alternative Cultures, residents of the Virtual Culture operate outside the boundaries of a specific institution. This culture actually has shattered most of the institutional boundaries, as well as the boundaries that exist between medical specialties. Peter Geerlofs, MD, one of McKenna and Pugno’s (2006, p. 100) frequently cited physician leaders, offers an expansive vision that results in large part from the introduction of new communication technologies:
“Even with managed care and the advent of large practices and IDNa, healthcare remains largely a cottage industry—with each organization or clinic operating as though it were an island. Physician leaders must help physicians grasp how infinitely better healthcare could be if we changed our minds and decided to operate as regional and national teams on behalf of our mutual customer—patients!”
While Geerlofs’ 2006 observations might seem a bit dated now, given the even greater impact of the Virtual Culture on the structure of healthcare organizations, there is still the sense that healthcare organizations operate as islands—thanks in part to the pushback by those aligned with the Tangible Culture.
More broadly, those involved in the emerging Virtual Culture find meaning in their work when answering the challenges of vastly expanded and accelerating knowledge generation and the growing capacity to disseminate medically related information. Those aligning with this culture tend to value the global perspective of open, shared, responsive information systems. These cutting-edge leaders are often identified as (and identify themselves as) “Geeks.” While they offer important new perspectives and practices, these physicians rarely are viewed as “leaders” in their health care system. We return to the observations made by Peter Geerlofs (McKenna and Pugno’s (2006, 97):
“’Geek’ physicians who love technology aren’t always the best leaders to help an organization transform. The nature of early adopters is that they are sometimes more interested in the technology itself than the transformed processes the technology could enable. They tend to quickly move from one new technology to another, never pausing to discover what it could do for the organization.”
