The Tokenism Paradox in Organizational Culture and Healthcare Leadership

You are the President and CEO of a leading healthcare organization, and the comprehensive Community Health Needs Assessment is complete for the next three-year period. It identifies the most critical health needs, chronic diseases, and issues that plague the service population connecting to your facility. One of the significant findings of your analysis shows that the ethnography and gender of your demographic are evolving.?

Research shows that representation matters concerning your clinical workforce, c-suite, and board of directors relative to patient outcomes. The current focus on addressing disparities, social determinants of health, and achieving health equity is paramount. The convergence of these themes sheds light on the paradox of tokenism intersecting in organizational culture and leadership.?

Tokenism is the cursory or figurative effort to recruit a small number of people from underrepresented groups to generate equality in the workforce. The first step for executive leaders might be to evaluate their existing structures, impose more diverse practices into hiring methods, or establish alternatives that change the landscape.

Critics argue that these tactical techniques can often generate perceptions of creative illusion, hypocritical gesturing, and a means to end protest and pressure. Others might assume that any breakthrough, no matter how limited, is a progressive step in the right direction and that changing culture is a slow process.?

Exposing implicit and normative behavior in our organizational cultures can be uncomfortable but necessary to foster effective change, facilitate dialogue, and implement sustainable strategies. What is the threshold for organizing our first steps, and how can we avoid false propositioning or the oxymoron of self-contradiction??

The Social Dominance Theory explores a personality trait that investigates the examination of an individual that supports the dominance of certain groups in alignment with race, gender, nationality, religion, or other similar factors (Sedanius and Pratto, 1999, p. 61). Rosabeth Moss Kanter's tokenism theory explores masculine and feminine norms. Kanter contends that once tokens reach a tipping point of 15% percent representation in the workplace, they experience fewer workplace problems.?

U.S. Census data reflects our changing population and implies that our national demographic expects a shift by 2044. Making a difference in this space requires we intentionally acknowledge our hierarchy systems, challenge our intergroup functionality, and understand the power distance that measures acceptance of our cultural leadership dimensions.

By leveraging our HR analytics, we can use data findings to map how to move forward. To be progressive, we must publish/create transparency around the information in our assessment (Even if it uncovers a messy truth). After recognition, we must educate our c-suite executives, leaders, workforces, boards, practitioners, patients, and other stakeholders vested in our healthcare delivery systems. Then, we must align our mission/vision/values to calibrate our intentions to develop new strategies. It is imperative to prepare the individuals we hire for our leadership positions so that they can navigate the nuances of our existing cultures and provide inclusive support that extends beyond the token visual implications.??

There are many actionable first steps. However, assessment, recognition, publishing, informing, educating, aligning, active engagement, and preparing the others (PTO) can create a competitive advantage.?