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Cover Stories | October 2019

Cultural Dexterity and Leadership

Rather than seeking diversity for its own sake, build a team that can collaborate and communicate.

I am a leader of an ophthalmic practice, and I happen to be a woman. I value first my own individual talents and gifts, my perspectives, and my intellect, and I reject being stereotyped or pigeonholed as part of a group. Even though I have experienced discrimination over the years and continue to do so, I consider my successes and failures personal.

If I had a dime for every women’s group that I’ve been asked to support over the years, I could likely retire. The segregation of the sexes that is notable in many women’s groups is specifically why I do not participate in them. Instead of focusing on issues that affect the workplace or society in general, these groups tend to focus on issues important to women. I find that the us-versus-them mentality that frequently results is unproductive. I support women, but I do so in the context of supporting their individual talents and hard work.

A women’s group may be fighting for diversity, or some form of diversity, but is the group itself diverse? I would say no because of the lack of male participation. A better solution would be a group that focuses on women’s issues but has diversity in participation.

I raise this issue at the start to set the stage for a discussion of diversity in a medical practice. There is much talk today about leveraging diversity—that is, unleashing the power of diversity to create value. Under this concept, a business or a practice hires a diverse workforce not for the sake of diversity alone, but rather to benefit from the multiple points of view, value systems, and perspectives that come with that diversity.

Unfortunately, to consciously achieve diversity in a workforce, we must see people as fitting into groups. This is the part of the process with which I have trouble. No matter the reason we are diversifying, when we begin to see employees or each other as a woman, black, Hispanic, disabled, or a variety of other groups, there is a peril of losing our special individuality.

Any attempt at leveraging diversity must be guarded for integrity; the unique individual must be the first consideration, before his or her age, sex, race, personality type, or other grouping is considered. With all of the education and hard work necessary to make oneself into an intellectually valuable team member, should one be expected to yield some uniquely competitive insight to a business just because one is a woman or a person of color? Please.

So, although I understand this strategy, there is a deep part of me that is repulsed by it. Being wanted primarily for one’s gender, race, age, or disability doesn’t feel good.


Leveraging is a word with many negative connotations. Look at the synonyms for leverage suggested by Merriam-Webster: to abuse, capitalize on, cash in on, exploit, impose on or upon, milk, pimp, play on or upon, use, work. Do you see any positive verbs in that list?

A concept that is more appealing to me than leveraging diversity is the term cultural dexterity.1 Berger and Berger use this term to describe business skills that enable effective collaboration and communication among people across multiple dimensions of diversity (Figure). The key characteristics of cultural dexterity are diversity and inclusion.

Figure. Dimensions of diversity.

Graphic recreated from Diverse Teams at Work, Gardenswartz and Rowe (2nd ed. SHRM; 2003)

When we consider diversity, we look at the full range of human and organizational differences and similarities in terms of attributes like generation, race, gender, ethnicity, and sexual orientation; but there are more than 20 dimensions of diversity to be recognized and celebrated.1

The real challenge in cultural dexterity is creating an environment of inclusion in which each individual believes that he or she is heard and supported. When both diversity and inclusion are achieved, productivity and collaboration are increased, and a greater sense of loyalty is created. When the transformation to cultural dexterity is complete, the impact on the business or practice is felt and a competitive advantage is realized.

Leadership is responsible and accountable for creating a diverse and inclusive culture, “one in which all employees clearly understand what success is and how to achieve it, and are effectively encouraged to participate,” according to Berger and Berger. Navigating today’s challenges and anticipating tomorrow’s opportunities require an expanded way of thinking. In that context, the diversity of an organization’s talent base may be its greatest asset.”1

An inclusive culture that encourages productivity, creativity, and loyalty begins with the practice leaders accepting personal accountability and examining their own biases and behaviors. Some day, I hope, diversity and inclusion will be natural attributes of all leaders—but today they are not. Still, what has been learned can be unlearned.

Berger and Berger recommend the following steps:

  • Acknowledge your own blind spots. Recognizing and admitting unconscious biases and prejudices are the first steps in neutralizing them;
  • Start the dialogue. Have open and authentic conversations to promote change;
  • Search for behaviors of exclusion. Whether exhibited by yourself or others, many exclusionary behaviors are unintentional, or even well intentioned, such as assuming a working mother would refuse a weekend travel assignment. Seek out and eliminate such behaviors;
  • Create an environment of advantages. Small, unintentional inequalities can become pervasive. Establishing a culture of inclusion fosters an environment in which small advantages are available to all—for example, candid feedback, special assignments, and invitations to contribute at meetings; and
  • Be a visible champion of cultural dexterity. Be an ethical leader, walking the talk. Take an interest and be involved with people outside your normal comfort group and social circles.

Practices that achieve cultural dexterity by building a diverse and inclusive environment position themselves to reap results that touch every area of the business. Cultural dexterity can provide greater business agility, better market insight, innovation, and improved employee recruitment and loyalty. I like these concepts of uniqueness and inclusion better than leveraging, even if maybe that is splitting hairs on a semantic difference.


With two children who are millennials and a third who is in generation Z, I was interested to read recently about a study that suggests millennials look at diversity differently than older generations.2

When millennials are asked what qualifies as a diverse workplace, rather than focusing on demographic features, they are more concerned with hiring those who have different cognitive viewpoints based on distinctive life experiences. Although differences in race or gender can play a role in those differing viewpoints, the features of race and gender are not diversifying characteristics themselves, in the millennial model.

A survey among more than 3,700 individuals spanning different generations, races, and genders found that “millennials frame diversity as a means to a business outcome, which is in stark contrast to older generations that view diversity through the lens of morality (the right thing to do), compliance, and equality.”

The author points out that many companies and institutions are not as progressive as millennials. The feeling is that the millennial viewpoint might harm groups that are traditionally helped by diversity initiatives. I’m not sure. We will have to see how this sort of demographic blindness affects business practices in the future.


By the way, I did recently join a women’s group, my first after 29 years in medicine. The reason I joined this one is because there was an all-male group that wanted a sister group of professional women to contribute ideas and perspectives. The men felt they were missing something. Having known many of these men for more than 10 to 15 years as good people, I felt honored to be asked. How could I say no?


1. Berger LA, Berger DR. The Talent Management Handbook: Creating a Sustainable Competitive Advantage by Selecting, Developing, and Promoting the Best People. New York: McGraw-Hill Education; 2011.

2. White G. Millennials have a weak definition of “diversity.” The Atlantic. May 13, 2015. theatlantic.com/business/archive/2015/05/the-weakening-definition-of-diversity/393080/. Accessed September 19, 2019.

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