Organization as Culture: International College of Integrative Medicine

The culture of the International College of Integrative Medicine (ICIM) is still developing as it comes into its own as a distinct, independent group. In this paper I will explore the emerging culture of ICIM , using Gareth Morgan’s metaphor of Organization as Culture from his book Images of Organization (2006).
ICIM uses the following methods to embed organizational culture: published formal statements, printed and promotional materials, our slogan, the “Pearls and Nuggets” ritual, careful word choices, and stories about the founders of the group.
The ICIM mission statement was carefully worded years ago to be a broad description of the organizational goals of the group. As we re-evaluate our mission statement, I hope to edit the wording to reflect the fact that ICIM is a close community of colleagues and that ICIM insists on scientific excellence.
Our policies and procedures document is a new project which has been co-written over the last year using contributions from numerous board members. The process has been organic, with lots of group revisions. The fact that our P&P document is a constant “work in progress” rather than a static, published set of rules says a lot about our organizational culture! It is also placed prominently on our website, showing that we value complete honesty, democracy and transparency in our office dealings.
Slowly, we are standardizing the design of all of the forms, letterhead and newsletters that we create, using a simple graphic of an “i” surrounded by a circle, and a wave, or as some call it, a “woosh” of blue sweeping across the top of the page. The simplicity of the small letter i surrounded by the symbolic wholeness of the circle expresses that we are a vulnerable group of doctors who are made strong by our commitment to holistic thinking and world class medicine. The curve of blue illustrates our belief that we are riding a wave of the future of healthcare and that we are on the cusp of a movement that will change everything. Even the color blue symbolizes truth and expression, something our organization strives to offer to wider society on behalf of our members. Within the circle around the “i,” our graphic sometimes fades to green, a color which symbolizes healing and healers.
The ICIM slogan is currently “dedicated to advancement in medicine.” I read this slogan as something with sad overtones. It is a reference to the past that we definitely need to replace and update. Culturally, our slogan betrays defensiveness from the rejection experienced by many in our leadership from the larger “mother” group American College for Advancement in Medicine (ACAM). When some of our founders were forced to leave ACAM it was as if they needed to express that their new group was still “dedicated to advancement in medicine,” and maybe the insinuation was even that we were the group that had the true “dedication” after all. Whatever meaning it had for the committee that first chose it, we must now find a new slogan that is proactive and sets a unique, positive tone to define ICIM to the public and its members.
Each medical meeting ICIM organizes includes a ritual that has become important to the culture of the group. We have a sharing time listed in the program as “Pearls and Nuggets,” During this period, participants are encouraged to describe things they are doing in their practice that are working well, sometimes even simple or surprising treatments. Doctors can also feel comfortable here to mention problems or failures that they have encountered and ask colleagues for ideas and support in how to face these challenges. This portion of the program displays an organizational culture that is supportive and non-competitive, and portrays ICIM, not as a group with insiders and outsiders, but as a community of people dedicated to exploring treatments that work and evaluating what doesn’t work openly with each other
In an emerging field that is struggling for an acceptable definition, linguistic subtlety takes precedent. Our board has spent many hours discussing the proper terms to describe our collective practice of medicine. Some of the words that have been rejected are “holistic” (too wide and vague), “complementary” (something harmless that is an additive to mainstream medicine; we try to offer a whole separate paradigm), “alternative” (sounds like something that rejects all modern treatment, which we do not do), “new age” (non-medical, spiritual, flakey association), or “natural” (insinuates herbs and teas instead of lasers and IVs). We try to avoid these terms to avoid confusion about who we are. ICIM doctors do not want to be seen as backwards quacks or out-of-touch spiritual fanatics. Words that have been deemed appropriate are “integrative” (integrating the wisdom of modern medicine with the acceptance of innovative, multi-cultural, and ancient understandings of healing) and “functional” (helping the body to function properly; doing what “works”) medicine. A standing joke is that, by this description, we are set apart from conventional doctors who practice “dysfunctional” medicine. ICIM doctors want to be viewed as high tech, cutting edge, and scientifically legitimate.
Stories about the founders of the group are fondly told in informal ICIM contexts, and recently we have begun to formalize this at each meeting by starting a tradition of honoring several long time members who have recently passed away. We give a plaque to the current owner of the practice as well as more personal certificate to the widow, signed by multiple friends and associates of the person being honored. Each time we do this, stories are told from the podium about the doctor which remind everyone to appreciate the sacrifices and bravery of these early pioneers in the field. A popular book among ICIM members is Medical Mavericks, by Hugh Desaix Riordan, MD (1988) which describes doctors throughout history who were persecuted or ridiculed for theories and treatments that later became mainstream. ICIM doctors see both themselves and the founders of their group as following in this tradition of medical mavericks.
Based on these specific examples of embedding organizational culture within ICIM, I identify the corporate values of democracy, innovation, community, participation, scientific validity and courage. Our process in creating policies and procedures identifies democracy and transparency. Our passion for innovation is illustrated by our graphic images. Our desire to be a close community will soon come out of our mission statement. Participation is shown to be an essential value through the ritual of “Pearls and Nuggets.” The careful word choice we use in all descriptions of what we do shows the value we put in scientific validity. And the stories and legacy of medical mavericks present examples of the value of courage in our organization.
My impression of the organizational culture of ICIM is that this is a group that is truly holistic in nature, with values that extend beyond medicine and celebrate the individual spirit of each member who identifies with it.







References

Morgan, Gareth (2006). Images of Organization. Thousand Oaks, California: Sage Publications, Inc.


Riordan, Hugh Desaix (1988). Medical Mavericks, Wichita, Kansas: Bio-Communications Press.