What does that mean?
It sounds like management claptrap.
Let me repeat it, and attribute it.
Culture eats strategy for breakfast ~ Peter Drucker
Anybody who has worked in a large organisation will know that we prize strategy above all else. It is an intellectual pursuit, highly valued in the boardroom. We hire consultants to write densely packed PowerPoint decks and they are debated at length. Yet culture rarely gets a second thought.
So why did Peter Drucker think it was so important?
An example:
In 1983 a medical intern called Joseph Michael Swango started working at Ohio State Medical Centre. Swango had graduated from Southern Illinois School of Medicine and this was his first placement. He was specialising in Neurosurgery.
Coincidences
Whilst he was working at the medical centre’s Rhodes Hall patients started to die. This was no real mystery, unfortunately people die in hospitals all the time. Though it did seem to happen when Swango was on shift. He was often seen wondering in a and out of patient’s rooms at odd times.
- A nurse saw Swango injecting a drug into a patient who went on to become seriously ill.
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Another patient claimed that Swango had injected her minutes before she had a seizure.
The nurses became worried. They thought it more than coincidental and raised their concerns with the head nurse.
Investigation
Hospital managers suspended Swango from his duties and investigated the allegations. A series of interviews were held and witness statements were appraised. The nurses complained that the investigation had been set up to discredit them and that the managers were only worried about reputational damage to the medical school. Eventually the hospital authorities dismissed the nurses’ claims as paranoia. They cleared Swango of all wrong doing.
The exonerated Swango returned to work in the Doan Hall wing of the hospital. Yet within weeks patents and staff in Doan Hall started to suffer from unexpected illnesses. On one occasion Swango bought the resident doctors fried chicken. Several of them became violently ill, yet Swango, who also ate the chicken, was fine.
Later that year the medical school’s residency committee reviewed Swango’s performance. They came to the conclusion he lacked the talent and ability to become a neurosurgeon. He was allowed to finish the first year of his internship, but was not invited back to complete the second. In July 1984 he left Ohio State. He was, however, awarded a licence to practice medicine.
Concerns abound
It wasn’t just Ohio State University where Swango’s behaviour raised concerns.
- As a student his class mates had given him the nick name Double-0-Swango as he appeared to have a licence to kill.
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Before his placement at Ohio State he was almost expelled from university. He only avoided it by hiring a lawyer, scaring the medical school enough to relent.
- Swango was fired from a part-time job as an ambulance driver. He made a man who was having a heart attack to walk to his car, forcing his wife to drive him to hospital.
Despite these incidents and many more Swango went on to practice medicine across the US then Zimbabwe, Namibia and Saudi Arabia.
Finally stopped
The Authorities finally caught up with Swango. In 1997 they arrested him and charged him with fraud. Investigations into his crimes continued and in 2000, two weeks before he was due to be released he was charged with three counts of murder. These included the unexplained death of Cynthia Anne McGee at Ohio State University, 17 years earlier.
At his trial exerts from his note book were read out. In one entry, Swango wrote of “the sweet, husky, close smell of indoor homicide”. Another suggested that murder was “the only way I have of reminding myself that I’m still alive”.
Swango is currently serving 3 consecutive life terms for murder.
It is estimated that he was responsible for between 35 and 60 deaths. That would make him one of the most prolific serial killers in American history.
The cover up
Mr Meeks concluded that the hospital should have reported the incident to the police at the time and asked them to carry out an enquiry. He was astounded to find that the hospital administrators had not kept a full copy of the investigation. He concluded that the first investigation was “superficial”.
How does culture eat strategy for breakfast?
Maybe it is unfair to single out the staff at Ohio State, Swango committed crimes in many other locations. But I do think it is fair to assume that the teaching hospital had its fair share of strategy papers, management consultants, mission statements, goals and targets. I also suspect that “patient care” was writ large across these. Yet when faced with a fully fledged serial killer, one who isn’t even hiding his tracks, the organisation closed ranks and covered the incident up .
The culture of your organisation is far more powerful than any strategy. If you don’t admit you have problems what hope do you ever have of fixing them?
What would your organisation have done?
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Read a detailed account of Swango’s crimes here
Image by Timothy Voges
A truly frightening story but one that illustrates that often we don’t see what’s right in front of our noses. Culture or cognitive bias or both?
I hadn’t thought of that Adrian, no doubt bias plays a part, one way or another.