By Larry Golson, OD
August 4, 2021
The old adage, “cash is king,” is due for a reboot. In so many ways, today’s research of organizational psychology is compelling: CULTURE IS KING. Practice culture directly impacts everything from how patients experience your office, employee satisfaction and loyalty, and ultimately, your bottom line. Whether you acknowledge it or not, your practice has a culture, positive OR negative. My practice’s culture, at one time, was negative.
Here is how my practice leaders and I developed a positive culture that ensures a high quality of patient care, a top-tier team experience and consistent, long-term growth.
Recognize the Need for a Culture Reboot
Our practice has an excellent culture today, but this was not always the case. Years ago, I lost my entire staff over a six-month period; hard to believe, but I’m sorry to say it happened. At that time, our office was not a place where people wanted to come to work each day. The markers that pointed to a negative culture were gossiping between team members, apathy and, at times, full-on sabotage. Most importantly, our culture turned sour due to a lack of great leadership, aka, my prior manager and me. In his book, “Extreme Leadership,” Jocko Willink argues that an organization’s success, or lack thereof, is ultimately 100 percent the responsibility of leadership.
Back in those days, rather than functioning as a team, my employees formed cliques, in which team members were aligned with subgroups (or subcultures) and eventually the house of cards tumbled. My lack of leadership finally resulted in a massive exodus of my team. If only I knew back then what I know now, right?
They say we learn the most from our failures, not our successes. This traumatic experience sparked in me a renaissance of learning and leadership cultivation using coaches, consultants and reading business and leadership books. Over the next few years and many missteps, like the phoenix rising from the ashes, a stellar culture emerged which provides exceptional patient care from a happy, high-performing team.
Identify & Live Out Practice Purpose & Core Values
Simon Sinek, in his book, “Start With Why,” identified that people won’t truly buy into a product, service or movement until they understand the WHY behind it. So I went back to the beginning. Why did I open this practice in the first place? For me, this exercise led to the identification of the PURPOSE behind our work and the CORE VALUES (CVs) that guide our daily behavior in our practice.Then, by instilling these foundational concepts into the hearts and minds of our team, the culture began to shift in noticeably positive ways. The revenue and profitability, although not our primary focus, began to improve inevitably in the wake of a blossoming culture.
At my practice, our Purpose is “to optimize the quality of life for both our patients and team members.” To bring that purpose to fruition, we realized we needed to focus on living out five core values: competence, commitment to excellence, candid team collaboration, innovation and accountability. The Purpose and CVs have to be known and owned by all, and our leadership consistently refers back to both as often as we can. We hire and fire, give raises and promotions, and measure performance depending on how aligned an individual is with these concepts. Lastly, since we are aware that each person interprets the same word or concept differently, we further defined our CVs below, so we are aligned and operating with the same understanding.
Competence: Our team members don’t like doing what they don’t know how to do well. Not fully understanding the intricacies of a job means added stress and irritability, poorer performance, a frustrated doctor and a diminished patient experience. Therefore, we created, and continually refine, an on-boarding protocol for every department and role within the office. Once more, team members are encouraged to inform their direct manager for more training when needed. In our practice, my manager keeps close tabs on the skill-sets of our team members. They have regularly scheduled meetings about duties and skills they may need additional training on to excel.
Commitment to Excellence: We seek to provide excellence in care and service to patients, and excellence in the support we provide to each other as colleagues. However, we don’t strive for perfection because that is not possible. Our culture emphasizes the importance of our office being a “psychologically safe” place to acknowledge mistakes and then learn how to do better next time. Once again, we as humans learn more from our failures than successes, so it’s OK to make a mistake in our practice. We think of ourselves as being in a state of constant improvement.
Candid Team Collaboration: For inter-team communication we use the model from Kim Scott’s book, “Radical Candor.” I love the subtitle of this book: “How to be a kick-ass boss without losing your humanity.” When I’m consulting for other practices, the most challenging issue cited time and again is the challenge of proper staffing. In our organizations, a good deal of discord stems from a lack of trust and communication with one another. Being a good boss is hard! Wouldn’t we all love to be a kickass boss or manager while maintaining our humanity? I believe Scott has the recipe. One of the central themes from her book is to care personally for team members while challenging them directly.
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It is part of our culture to offer one another direct feedback UP and down the hierarchical structure on an ongoing basis. You read that correctly; my managers and I require our team to tell us what we can do better for them as their leaders. Our team comes to us regularly with suggestions about how we can better manage patient flow, the possible need for new instrumentation and the challenges they are having with one another. We talk directly about needed changes instead of whispering or gossiping about annoyances or unsolved challenges. If we have a team member not behaving in this manner, we offer a 1-2 month Performance Improvement Plan, and if the poor behavior persists, we liberate him or her from our practice.
Innovation: We recognize that eyecare and technology are both rapidly evolving. To keep pace with these changes, and continue to deliver superior care and service, we need to be comfortable with change. Rather than getting set in our ways, we have a continuous conversation about how the practice can change to accommodate new patient needs and expectations. For instance, we added a second doctor and started implementing principles from “Traction,” a book which details an “entrepreneurial operating system” by Gino Wickman. Both of these changes required us to adapt our office routines and upset our comfort level.
Accountability: In Traction, Wickman says the level of accountability among a team will dictate how successful the business is. That means that, as an integral part of our culture, each of us takes responsibility for following through on the tasks that are part of our job. We aren’t perfect, and yet we strive to become more accountable as we develop as team members.
It’s interesting to note that team members come to our leadership on a regular basis describing how the concepts learned in our practice are used to improve their home life with friends and family. We take a great pride in having that kind of effect on our personnel.
Great Culture Ultimately Leads to Great Profitability Growth
As you refine and improve your practice culture, watch your practice’s key performance metrics rise. If the culture you are creating is beneficial to patients, team members and the practice, you will notice an upward trajectory in profitability. Since improving our culture, my practice has experienced 12 percent year-over-year growth in annual revenue, which continues to increase as we gain traction. Equally important, our team and patients love their experience of our office!