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Creating a Culture for Success at Your Medical Practice


Medical practices have traditionally focused on patient care, leaving the business end to administrators. Now, as health reform advances, practice models are rapidly changing. Here's how to embrace the changes.

Talking about the concept of "culture" and "creativity" in reference to medical practices can be both intriguing and scary. Most practices want a culture of stability, not one that faces constant change! However, while the old adage says two things are certain - death and taxes - I would add a third - change.

The traditional culture within medical practices has been one that focuses on patient care. The primary goal was meeting patients' needs - one that most physicians found thoroughly rewarding. This practice model has worked well for most physicians; satisfying patient needs and allowing physicians to achieve their economic goals. However as health reform advances, practice models are rapidly changing; and there is not much that can be done to stop it.

Rather than resist change, practices can survive by working together, recognizing each staff member's needs and issues, and dealing creatively with daily challenges in a positive, effective manner.

Each practice has its own unique culture but can learn from other practices how they are dealing with the changes at hand.

Strategies to weather change

Here are some ways to change your practice culture so that it is both creative and prepared to survive the future:

• Create an attitude where everyone in the practice needs to participate in changing the present culture. Each staff member has good ideas that when brought out in the open can create the ultimate outcome of improved care for each patient served in your office.

• It is also important to know that when everyone works together there will be better results; the team is more effective in implementing change than just one individual.

• Openly talk about how things are done. Find out which staff member has knowledge in areas that need to be fixed - let him take the lead in changing "how we've always done it."

• Change the "sticky notes" that have been hanging around desks and in the break area for months or years. Spruce up your work environment - it makes a big difference.

• Use symbols that can help remind your practice of the value of positive change and the strength of good attitudes. Toyota uses a rope (called an andon cord) to stop the assembly line when something is wrong. Practices can't stop seeing patients, but when things go wrong, they can be reminded to make a note and talk about it later on - often by openly discussing a problem it can be prevented from happening again.

• Do a daily or weekly huddle, again using open communication, but use this time to review what happened yesterday and what may be the bottle necks for the day ahead.
• Share positive stories and successful patient outcomes with staff members.

• Recognize each other with a friendly greeting in the morning, thank each other for a job well done, and find ways to reinforce the behavior that you want and expect.

• Talk and think positively. It is easier to draw on strengths rather than remove barriers.

Don't forget, change starts at the top. Physician owners and leaders, as well as practice managers, must see the need for and be open to creative change; recognizing that every staff member can have a lot to offer. Getting everyone involved is just the first step in a long process to removing resistance to change. Communicate your support for creating a new attitude and don't give up! Ultimately it will improve the care your practice provides to each and every patient.

Owen Dahl, FACHE, CHBC, is a nationally recognized medical practice management consultant and author of “Think Business! Medical Practice Quality, Efficiency, Profits,” “The Medical Practice Disaster Planning Workbook,” and coauthor of “Lean Six Sigma for the Medical Practice: Improving Profitability by Improving Processes.” He can be reached at or 281 367 3364.


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