Can your team see, discuss, and change its own culture? If not, risk is hiding in plain sight.
What Is Culture?
Culture is how we work together:
- How we make decisions and set priorities.
- How we share feedback and hold one another accountable.
- How we use power and authority, formally and informally.
- How we surface disagreements, or don’t.
- How we celebrate wins and learn from failures.
- How we address, or fail to address, root causes.
In short, culture is the human operating system that turns strategy, science, clinical expertise, resources, and technology into results.
A personal lesson. Early in my career as a systems engineer and tech team lead, I learned the importance of culture the hard way. My IT team hit every project milestone, on time, on budget, and met every objective, yet when it came time to renew, we still lost the client. Why? Difficult interpersonal dynamics had eroded trust and had become a barrier to a successful business relationship.
Later, as a partner in a consulting firm during a key transaction, my partners and I left serious money on the table, not because of a bad market or flawed services, but because we couldn’t agree on, or even talk about, the issues that mattered most. Both experiences taught me: no matter how smart your strategy, culture eats it for breakfast.
What Is Cultural Intelligence or “CQ”?
Cultural Intelligence, or CQ, is the ability to see and understand how culture impacts results and to have the agency and skills to do something about it. This includes not just business outcomes like financial performance, quality, customer satisfaction, innovation, compliance, or safety, but also human outcomes like engagement, retention, trust, and collaboration.
In clinical, scientific, bio/pharma, and healthcare environments, this matters because the stakes are often higher than the next quarter’s numbers. Culture can affect patient safety, scientific integrity, product quality, regulatory outcomes, speed to discovery, and the ability to catch weak signals before they become serious failures.
Here’s a quick way to think about it:
If you can read your team dynamics as clearly as you can read a lab report, a clinical protocol, a trial design, a code base, a safety signal, or a financial analysis, you have high CQ.
If human dynamics sometimes confuse you, or if you’re unsure how to address patterns you see, or feel your team is not changing fast enough, then your CQ may need strengthening.
This has always mattered. But today, the expectations are higher: employees and stakeholders are looking for real cultural leadership, not just operational management, from those in charge. Leading your culture is not one of those jobs AI can do for you, and you can’t expect HR to take care of this on their own.
Leaders who build CQ in themselves and their teams gain a massive advantage: they can diagnose issues earlier, adapt faster, with less drama, and lead cultures that deliver both performance and human resilience.
When Culture Turns Deadly
Culture-work is often fun, even joyful, and should not be seen as only focused on correcting a problem or addressing a failure. It is often about increasing flow, happiness, and enjoyment at work. It’s about delighting clients, patients or customers, improving the work experience for the staff, strengthening loyalty, and helping smart people do their best work together. Product or service features are easy to copy, but a strong culture is a competitive advantage, with customers and employees, that is hard to duplicate.
However, when I saw the recent documentary about the Titan tragedy, I had to take notice.
Netflix’s “Titan: The OceanGate Disaster” shows how dissenting engineers were marginalized, safety warnings dismissed, and a “founder-knows-best” mindset drove fatal decisions, prompting one former director of engineering to say, “Culture is what killed the people. 100 percent.”
This was the belief of the former director of engineering, not the head of HR.
NASA’s 1986 Challenger inquiry reached the same verdict almost 40 years ago: managers ignored engineers’ O-ring warnings, prioritizing schedule over safety.
These examples may seem far from the day-to-day work of a hospital unit, research lab, clinical development group, manufacturing site, engineering team, or scientific leadership team. They are not. The dynamics are familiar: dissent gets softened, bad news travels slowly, authority overrides expertise, teams become too polite to challenge assumptions, or people learn that raising concerns is professionally risky.
And let me be clear: in both Titan and Challenger, it seems all the leaders involved sincerely wanted to be safe. The CEO of OceanGate, quoted in the documentary, says he had a granddaughter he planned to see grow up, that “no one will die on my watch,” and that the company should fail rather than be unsafe. I have no doubt these feelings were true. But clearly it was not enough to counter other forces at play in the culture and avoid a tragic outcome.
Good intentions do not automatically create a safe or high-performing culture. In high-stakes scientific and clinical work, the question is not whether people care. They usually do. The question is whether the culture makes it easy enough to speak up, challenge, listen, learn, and act before the consequences become serious.
Why This Matters to Every Leader
Leadership behavior sets the tone. A 2022 MIT Sloan Management Review study found toxic culture is most strongly predicted by toxic leadership and group norms.
Healthy culture drives results. McKinsey’s 2024 research shows organizational health remains the single best predictor of long-term value creation.
Whether you’re developing a therapy, running a lab, leading a clinical team, managing quality, improving hospital operations, or launching spacecraft, ignoring culture is an expensive gamble.
In bio/pharma, healthcare, and scientific organizations, culture shows up in very practical ways:
- Whether people raise concerns early or wait until the data, the patient experience, or the project forces the issue.
- Whether scientists, clinicians, operators, quality leaders, and commercial teams can challenge each other productively.
- Whether meetings surface the real issues or simply confirm what senior leaders already believe.
- Whether teams learn from near-misses, deviations, failed experiments, safety events, or handoff breakdowns.
- Whether root causes are actually addressed, or whether the organization settles for easier explanations
The culture is already shaping results. The only question is whether leaders are shaping it consciously.
The Three Capabilities of High-Reliability Teams
See the culture: Make the invisible visible with real data: surveys, 360s, stakeholder interviews, behavioral observations, meeting observations, after-action reviews, near-miss analysis, and patterns in rework, quality, safety, or decision delays.
Discuss the culture: Create psychological safety and constructive conflict. If people can’t challenge assumptions, question authority, name risks, or tell the truth about how the work is actually getting done, you’re flying blind.
Change the culture: Align behaviors with your mission and strategy. Preserve what works, fix what doesn’t, and measure progress. Culture change is not a slogan. It is the disciplined work of changing the conversations, decisions, routines, and leadership behaviors that drive results.
These steps echo the conflict-resolution roots of the Harvard Negotiation Project: tough issues become solvable only when they’re named and examined openly. That which is not discussed will eventually become undiscussable.
Try This: Put Culture on Your Next Agenda
Open with evidence. Bring one data point: retention, wasted time, decision delays, handoff failures, quality events, safety concerns, deviation trends, patient experience data, failed experiments, or a near-miss that culture likely influenced. Ask: What are the key components of our culture? How do they support, or obstruct, our mission?
Run a “Titan Test.” Ask: Which warnings are we not hearing? What is important that we are not talking about? Where might we be allowing confidence, hierarchy, speed, or optimism to overpower expertise?
Map See-Discuss-Change gaps. Choose one habit to start or stop this quarter. Ask: If we are to be the masters of our culture, where should we start?
Small, disciplined moves beat heroic speeches.
You don’t need a documentary, a failed trial, a patient safety event, a regulatory finding, a major quality issue, or a disaster to start building a better culture. You just need the courage to ask the right questions, and the will to act on what you hear.
A Humble Invitation
If you ask these culture questions and are not sure how to respond to some of the answers you hear, let’s talk.
I don’t build submersibles, reactors or rockets. I don’t run hospitals, labs, or clinical trials. But for 30 years I’ve helped leaders and teams in those environments make their cultures safer, smarter, more productive, and more resilient.
Let’s build cultures that are not only fast and innovative, but grounded in trust, curiosity, candor, and the courage to act before the warning signs become consequences.
References
- Netflix documentary Titan: The OceanGate Disaster, 2025.
- Space Shuttle Challenger disaster findings, U.S. Rogers Commission Report, 1986.
- MIT Sloan Management Review, “Why Every Leader Needs to Worry About Toxic Culture,” 2022.
- McKinsey & Company, “Organizational Health Is Still the Key to Long-Term Performance,” 2024.
- Harvard Law School, Program on Negotiation, Overview of the Harvard Negotiation Project.
