Meaningful culturalization in an academic hospital: Belonging and difference in the interference zone between system and life world

Purpose – In this chapter, we explore how normalization of exclusionary practices and of privilege for seemingly same professionals and disadvantage for seemingly different professionals in academic healthcare organizations can be challenged via meaningful culturalization in the interference zone between system and life world, subsequently developing space for belonging and difference. Methodology – This nested case study focusses on professionals’ narratives from one specific setting (team) within the broader research and research field of the Dutch academic hospital (Abma & Stake, 2014). We followed a responsive design, conducting interviews with cultural minority and majority professionals and recording participant observations. Findings – In the Netherlands, the instrumental, system-inspired business model of diversity is reflected in two discourses in academic hospitals: first, an ideology of equality as sameness, and second, professionalism as neutral, rational, impersonal and decontextual. Due to these discourses, cultural minority professionals can be identified as ‘different’ and evaluated as less professional than cultural majority, or seemingly ‘same’, professionals. Furthermore, life world values of trust and connectedness, and professionals’ emotions and social contexts are devalued, and professionals’ desire to belong comes under pressure. Value – Diversity management from a system-based logic can never be successful. Instead, system norms of productivity and efficiency need to be reconnected to life world values of connectivity, personal recognition, embodied knowledge and taking time to reflect. Working towards alternative safe spaces that generate transformative meaningful culturalization and may enable structural inclusion of minority professionals further entails critical reflexivity on power dynamics and sameness–difference hierarchy in the academic hospital.