Measuring the culture of medical group practices

To develop an instrument that can be used to assess the organizational culture of medical group practices.

Study participants were primary care physicians in 267 medical group practices. The iterative process began in Minnesota and then expanded to practices in 21 other states.

Practice culture statements were collected using questionnaires distributed at a national medical group practice meeting and mailed questionnaires sent to a broader set of participants identified by the Medical Group Management Association.

Using a framework developed earlier, physicians in medical groups were asked to react to statements that described the basic assumptions and patterns of behavior characteristic of their practices. An iterative process involving over 500 physicians in 267 practices was used to identify and refine statements. Factor analysis was used to group the statements into cohesive cultural dimensions.

Thirty-nine statements correlated with nine cultural dimensions were identified and a test of this instrument found that it successfully identified differences in the cultures of medical groups.

Although there is increasing agreement that the culture of medical group practices is one of the most important factors influencing the cost and quality of care, efforts to understand and manage these cultures have been hampered by the lack of a measurement instrument. This article presents an instrument that has broad face validity in the group practice field and successfully differentiates the cultures of different types of practices.