Orthodontic Office Cultural Relevance by Jay Geier

A great practice culture is also a profitable one—but creating one requires work, not just money

by Jay Geier

Once your practice has reached its physical capacity to treat more patients, your revenue is destined to plateau. If you want to grow beyond that limitation, you have to invest in additional space and equipment by adding treatment rooms, moving to a larger office space or adding an additional location. Those options typically require substantial financial investment.

But without a great office culture, even the most beautiful, state-of-the-art practice may never see the ROI it’s capable of. Building and nurturing the kind of culture that benefits your patients, your team and your community is foundational to all other success. Unlike everything else you do—marketing, pricing, employee pay, décor, community involvement—your culture can’t be copied; it is unique to your practice. This “secret weapon” is your single best competitive advantage, if you are intentional about making it that way.

A great culture can’t be bought; you can’t just write a check and instantly “have it” like you can with a building or new space. That’s a good thing, because otherwise every practice would have one. However, unlike building out your office, which entails other people doing the work, building your culture requires that you do most of the work.

Invest some real heart in the team engagement part of your culture-building process! These small behavioral changes on your part require no monetary investment, but will pay huge dividends in how your people feel about you and working for you. (And, frankly, they will make you a better person in all facets of your life.)

Relational versus transactional relationships

A transactional relationship is one in which both or all parties are in it for themselves: They do things for others only when they can expect to get something in return.

In contrast, being relational means living in recognition and appreciation of an interconnectedness with others. Attributes of relational interactions include engagement, appreciation, empathy, forgiveness, authenticity, honesty, generosity, humility and kindness. Relational people are in it longer term, value deeper friendships more than surface acquaintanceships and genuinely want the best for all involved.

Patients who show their appreciation for treatments, thank the staff and refer others are being relational. Those who barely acknowledge anyone on the team and complain about any co-pays or the patient portion of their bills are being transactional; you’re being paid for what you did, so why should they feel grateful? It was a mere transaction.

When you rush through an explanation to another team member or patient, you’re being transactional: Your time is more important to you than ensuring the team member or patient is fully benefiting by truly understanding. Clearly, that’s not good for the team member or the patient—and therefore, not the business.

When you hire a new team member, you enter into a transaction: You agree to pay them a certain amount for the specified work. What happens from that point forward reflects whether your culture is relational or transactional. If that person habitually shows up late, does a marginal job at best and is a poor team player, but expects to get paid the same no matter what, that’s a transactional relationship. If you allow that to continue, you are reinforcing a transactional culture.

Even if someone is doing a good job, if their primary motivation is “bucking for a promotion” so they get paid more, that’s self-interest versus genuinely caring about helping you grow the practice, develop the team and better serve patients. They’re not team players; they only care about themselves. You can’t build a relational culture with transactional people.

Building a relational culture

You need to be the one to throw out the first pitch to get the game started with the team. Identify some of your own transactional behaviors and modify them to be more relational. The following tips will give you a great place to start when building a great culture (but don’t be surprised if, at first, you hear people whispering behind your back, “Who is that, and what have they done with the doctor?!”)

Walk among the troops. Don’t always wait for formal status meetings; spontaneously sit down next to someone and ask, “How are things going? What are you working on?” They may look worried the first few times you do this, but they will come to appreciate your interest and the opportunity to interact with you one-on-one.

Remember people’s names. Unless you have a huge practice and new people starting all the time, there is no excuse to not remember the names of the people without whom you could not stay in business. Your patients appreciate name tags on your team members, so get them for your own benefit as well. And of course you would greet every patient by name.

“Do for one when you can’t do for all.” For example, if a team goal is missed but one person did an exceptional job above all others, acknowledge and even reward them for it. If a team member is in dire need for some reason, do something to help without worrying about setting a precedent.

Celebrate small successes. Sustain and build momentum toward big goals by recognizing and celebrating the results that come from all the incremental changes that ultimately lead to the big wins.

Give “drive-by compliments.” Even the smallest recognition, such as a thank-you, is most appreciated in the moment. Don’t wait for scheduled recognition events to acknowledge and say thank you for the last month’s or quarter’s accomplishments. It appears they weren’t important enough for you to notice at the time.

Give small gifts. It truly is the thought that counts. Small, inexpensive gifts are greatly appreciated when thoughtful and timely.

Praise publicly. When patients praise you, immediately share it with the team in front of the patients; team members and patients will be impressed that you share the credit. Also, reinforce desired behaviors in all team members by praising individuals in front of the others.

Say thank you—a lot. A simple thank you speaks volumes, especially when you don’t have to or when the person says it’s completely unnecessary. Maybe so, but it will mean a lot to them.

Catch people doing things right. Look for and acknowledge all the little things that are being done right and going well. Doing so will cause the not-so-good things to pale in comparison, and motivate people with positive reinforcement instead of fear of being caught doing something wrong.

A great culture has profit in mind

The more you begin to do these things, the more you’ll want to. It will make you feel good to see how good you make others feel. You’ll also be able to assess who’s being engaged by this aspect of culture-building and who isn’t. You can’t build a relational team culture with transactional individuals. By recognizing and rewarding people for following your lead, you will be developing their capacity to be relational as well.

A lot of clients who attended our most recent Culture Fest event, which helped doctors and key team members develop a great office culture, said they realized they simply weren’t good at giving praise. We challenged them to put that excuse aside and, if needed, to set a time in their calendar to plan out their praise. Once you’re in the habit of praising people around you and see their responses, you’re more likely to continue.

If all this sounds too touchy-feely, let me reiterate the impact a great culture has on the success of your business—how well you serve your patients, how well your people perform as individuals and teams, and how motivated and accountable they are to meet practice growth goals. In other words, a great culture is also a profit-minded culture. You are, after all, in business to make a profit so you can keep serving your patients and growing the business so you can help even more people. 

Jay Geier is the founder and CEO of Scheduling Institute, a firm that specializes in training and development, and coaches doctors on how to create a performance-based culture that drives business results. The phenomenal growth of Scheduling Institute is a result of Geier practicing what he preaches, as he has always applied these same philosophies to his own team to help them live up their full potential.

To learn more about the next Culture Fest event, or for a free assessment to find out if your team is living up to its full potential, visit schedulinginstitute.com/townie. To subscribe to Geier’s “Private Practice Playbook” podcast, go to podcastfordoctors.com/townie.