Don't Wear Business-Casual Ethics in Your Hospital

The Resident, an American medical drama television series, aired on Fox between 2018 and 2023, and fans can now find it on Netflix. The series focuses on the lives and duties of staff members at fictional Chastain Park Memorial Hospital, with a critical eye into real life bureaucratic practices and ethical dilemmas of the healthcare industry.  

The show tackles contemporary issues within the healthcare industry, such as medical ethics, the influence of corporations on healthcare, and the challenges faced by medical professionals. These themes resonate with audiences who are interested in understanding the complexities of the healthcare system.

Writers for The Resident didn’t shy away from critiquing the healthcare system, often highlighting issues such as patient mistreatment, medical errors, and the prioritization of profits over patient care. This critique resonates with viewers who have experienced similar frustrations within the healthcare system or fear they might. Even though the writers developed multi-dimensional, often likable, and heroic characters, in general, it’s no friend to the healthcare industry and creates doubt about the ethical behavior of clinical and non-clinical hospital decision makers.

To establish and augment a hospital’s culture, leaders have the responsibility to teach the organization’s core beliefs to employees without disrupting or challenging ethics. What does that mean? Drawing from the work of social psychologist Robert Ciladini, consider these six principles for influencing the ethical behaviors of others:

1. Reciprocity: Give to get but give first. Make top performers want to work for you personally. If you give first—not just a paycheck but other benefits like information, service, concessions, choice assignments, or attention—they will feel obligated to reciprocate.  Further, if you build a culture of reciprocity, you will find members “policing” the reciprocity. That is, a sense of fair play will emerge that demands employees show their loyalty to the company and to each other.

2.  Consistency and Commitment: People want to feel consistent with what they have said and done in the past, especially when they have done it publicly. Therefore, give and elicit promises. When people write down a goal, they increase their chances of accomplishing it. When they write it down and then say it out loud to others who depend on them, they significantly increase the rate of follow through.

3.  Inclusion: People frequently decide what to do in a particular situation by observing what others have done. Average employees will want to do what the high potentials do, so emphasize what everyone can do to align with the best and brightest.

4.  Rapport: People respond favorably to leaders they like or respect, especially if these leaders communicate that they care in return. When leaders express their appreciation of people in the organization and point out how employees embody admirable behaviors, employees start to feel both included and liked, which engenders more of the desirable behaviors.

5. Authority: People frequently defer to a person they perceive as knowledgeable because doing so gives them a decision-making shortcut and aligns them with those whom others admire. Fill your hospital with knowledgeable, trustworthy experts whom others can claim as peers, and you’ll soon find you have built a culture characterized by both ethics and expertise.

6.  Scarcity—The Rule of the Rare: People want more of something they consider scarce. If you build an organization that hires only the best, you create a kind of exclusive “club” that others want to join. You don’t offer membership to all, only those who want to work hard and do great things—ethically. Become a collector of rare performers, and you’ll find your collection can outperform all others. If you communicate the exceptional nature of both your organization and your employees, you create a talent magnet—and a culture where employees can’t stand the idea of losing anything to the competition.

Ethical behavior defines philosophical conditions that guide your organization—not just a set of protocols. Integrity must form the foundation of your culture and drive all other decisions, but before that can happen, leaders need to identify the beliefs and behaviors that will march in lock-step precision with ethics in all kinds of conditions.