The popular Web site *Investopedia* offers a succinct definition in a well-written introduction to the concept(1): Corporate culture refers to the beliefs and behaviors that determine how a company’s employees and management interact and handle outside business transactions. You can create culture *intentionally*, or you can let it happen *unintentionally* — often with unintended results.
As I have observed several times before, top-performing medical practices have a different “feel” that you can sense almost the minute you walk through the front door. Patients might notice it—but then again, they might not. Much of the atmosphere I am talking about is characterized by what is missing: chaotic and (sometimes) noisy reception areas; incessantly ringing telephones; abrupt, dismissive or rude responses from staff members; long wait times with no explanation or apology; and disheveled work areas and poorly maintained waiting rooms. You know what I mean—the list goes on and on . . .
Top performers—smooth-running, efficient practices that consistently produce well above average profitability—almost always present a different kind of ambiance to patients and visitors. No matter how busy they are (and top performers usually see far more patients than average), you get the sense that you are watching a well-oiled machine. Everyone knows his or her job and discharges those responsibilities efficiently, professionally, and often with a smile.
Building Your Office Culture
Before we go any further, let’s make sure we understand what we mean by a company’s culture. The popular Web site Investopedia offers a succinct definition in a well-written introduction to the concept(1): Corporate culture refers to the beliefs and behaviors that determine how a company’s employees and management interact and handle outside business transactions.
The physicians and managers of every medical practice are constantly building, developing, and modifying the corporate culture of the company. You can create culture intentionally, or you can let it happen unintentionally—often with unintended results.
People who work together in an office normally want to fit in with the group. They will adapt to the values and expectations demonstrated by the group, or they won’t last long. Exceptions to this principle are uncommon, but people with antisocial (even pathological) tendencies do not worry much about fitting in, and workers who feel desperate to keep a job can maintain the appearance of fitting in even as their hearts disagree with the value system in place. Preventing those misfits from joining your staff is a matter of effective applicant screening—a topic for another day. As for the staff you already have, they will adapt, more or less, to the culture that exists among the leaders of the practice.
The most dysfunctional medical group I ever managed was made up of about 15 surgeons who could hardly stand each other—in fact, they did not really want to be in a group! Greed had driven them to accept an enticing high-dollar offer from a physician practice management company. I found myself trying to lead the most contentious, resentful, and uncooperative bunch of employees I have ever seen. (By the way, I only lasted about six or seven months there!)
Teaching Values to Your Workers Intentionally
There is an old saying, “Values are caught more than they are taught,” but that is only partially true. If you make no effort to teach values and beliefs, those under your direction will be left to figure them out themselves—catching what they can. The trouble is, you never know what they will catch.
If you cannot articulate what you want your students to learn, you have little chance of getting your point across.
In education courses, we learn the critical importance of developing good instructional objectives before we develop a curriculum, a course, a lesson plan, or even a classroom activity. If you cannot articulate what you want your students to learn, you have little chance of getting your point across. Because employee training commands a large portion of any manager’s time and energy, it will benefit your practice greatly to learn (and use) a few solid pedagogical principles.
Classic instructional objectives include three types of goals:
Cognitive: goals that focus on knowledge and information. Cognitive goals answer the question, What do I want my students to know?
Conative: goals that focus on skills and action. Conative goals answer the questions, How do I want my students to act on this knowledge? What skills do they need to accomplish that?
Affective: goals that focus on feelings and attitudes. Affective goals answer questions like, How do I want my students to feel about it?
This oversimplified breakdown can help you better plan every training session around the practice. If you discipline yourself to ask these questions as you plan training courses, write a speech, or create a PowerPoint presentation, you will improve your effectiveness greatly.
Your daily encounters with staff present dozens of “teachable moments.”
As a matter of fact, you can revolutionize your management effectiveness by learning to think like this. Your daily encounters with staff present dozens of “teachable moments.” Giving instructions, correcting errors, even disciplining a wayward worker—all can be viewed as employee training. You are refining and (hopefully) improving your staff as you clarify expectations and responsibilities. The next time you ask a staffer to come see you in your office, quickly ask yourself what you want him or her to learn from this encounter.
Including Values in Your Employee Training
Including values in your employee training sounds fairly straightforward—at least in theory! Making it effective requires considerable finesse, however. You cannot just tack a unit of “values” onto your favorite insurance-processing course, unless you want to see employees roll their eyes in jaded disbelief.
No, you have to interweave your practice values throughout your training. You communicate the values—especially to new employees—through the way you talk about patients, providers and colleagues. You communicate it with tone and word choice. It can be subtle, but you can be explicit as well.
Hopefully your practice has worked out clear and accurate vision and mission statements. You need to develop a list of “core values” as well. Too many practices do little with these statements beyond memorializing them in framed wall decorations and printing them in the first few pages of the employee handbook.
Include your mission and values in your new employees’ orientation. If you do not review them with new workers, they probably will not take them as seriously. Be ready to articulate and explain each value statement—and give examples of how each value works out in day-to-day life in your practice.
Practice What You Preach
Never forget that employees are seldom, if ever, fooled by the boss. If you do not genuinely care about the human beings who come to you for medical treatment, do not be surprised if your staffers tend to treat them in a callous manner. Patients will soon report that at your practice they feel like “a number”—not real people with real problems, real fears, and real needs.
For example, do not pass your clinic off as a “patient-centered practice,” then act as if everything revolves around the doctor. Face it: most patient scheduling systems have been designed to reduce physician idling and amp up their productivity. Who cares how long the “laypeople” have to wait? For years we have demonstrated to the public that patients’ time is not as valuable as the doctor’s.
Some years ago the media introduced a new phrase to the viewing public: credibility gap. It referred to our skepticism over what public figures claimed to be true. (Interestingly, it was first used to describe Americans’ doubts about the President Johnson Administration’s claims concerning the war in Viet Nam.) If your approach to values training starts to sound like, “Do as I say—not as I do,” you will develop a serious credibility gap of your own.
Values can indeed be taught, but what is caught will overshadow anything you try to teach to your employees.
Corporate culture. Investopedia; www.investopedia.com/terms/c/corporate-culture.asp. Accessed September 1, 2016.