These traditionalists find meaning in the roots of health care – Hippocratic Oath and all. Integrity is all important in the Tangible Culture. McKenna and Pugno (2006, p. 134) contribute their own thoughts about the role played by integrity within the traditions of healthcare:
“Integrity is essential for success as a physician leader. Other words, such as “trustworthiness” or ‘High moral values” may be substituted, but the point is that integrity is consistently identified as the number one reason why an individual is considered capable of leadership. Integrity is the number one reason why others will follow someone.”
With integrity as the foundation, those aligned with the Tangible Culture find meaning and purpose in establishing and maintaining healthy “trustworthy” communities. Furthermore, they often look for and appreciate the spiritual grounding of these communities. McKenna and Pugno (2006, p. 151) comment on this spiritual orientation:
“While physicians’ religious backgrounds are, of course, as diverse as those of the patients they treat, most physicians share a deep regard for the sacredness of life. And for many, that includes a respect for patients’ spiritual condition, as well as their physical and emotional health status.”
Thus, for McKenna and Pugno, this spiritual orientation—which stands hand-and-glove with integrity in the Tangible Culture—leads not only to support of a spiritual foundation in the healthcare communities they join and the sense of being engaged in a “sacred” pursuit as a health care provider but also an appreciator of their patient’s spiritual life.
Even more broadly, tangible-oriented physician leaders cherish the predictability of a value-based, face-to-face encounter with patients. While the Virtual Culture operates at a distance from the patient (a distal perspective), the Tangible Culture operates at a close personal level with the patient (a proximal perspective). Wearing the traditional uniform (white coat and stethoscope, or colorful smock or scrubs), the tangible physician leader prefers (usually requires) that their patients always come to a specific physical location—usually the physician’s office. As a rule, they also insist on being called “Doctor” rather than being called by their first or last name. These healthcare leaders often hold untested assumptions about the ability of old systems and technologies to address current healthcare challenges. In the role of teacher, supervisor or mentor, the tangibly oriented physician leader looks forward to instilling long-standing caring values in newly minted physicians. Ultimately, their institution’s chief enterprise is to honor a fundamental medical legacy: abate illness and heal wounds.
In some ways, the Tangible Culture is the oldest of all healthcare cultures’ however, it operated in a very tacit manner being just the “given way” in which those working in healthcare thought of their work. After all, healthcare has been around in some form as long as humans have been ill or wounded. Nevertheless, it is only in recent years that the Tangible Culture has emerged as a distinct entity with its own champions. As is the case with those operating in the Virtual Culture, those who helped to reinforce the Tangible Culture needed to find ways to form alliances with the existing cultures. The alliances that have been formed tend to be appreciative (Bergquist, 2003; Cooperrider and Whitney, 2005). The Tangible Culture is not in the business of helping to improve the functioning of the other cultures (an aspirational perspective); rather, the Tangible Culture is intended as a vehicle for acknowledging and honoring (appreciating) the contributions being made presently by the other four cultures. The only “improvement” to be made is ensuring an allegiance with those in the other four cultures (particularly the Alternative and Advocacy Cultures) who reside in the institution where they are all operating.
