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
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
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
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
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.