What are five signs that your practice has a rotten culture?

by Michael Jones

With the public health emergency and the impact of Covid on the overall workforce, we’ve all become even more familiar with terms such as “The Great Resignation” and “toxic culture.” Especially in the overburdened healthcare industry, with many clinical and support departments experiencing shortages of employees or shifts in employee responsibilities, the topic of workplace culture has become even more critical.

In a 2022 article, author Kate Heinz shared 16 examples of a toxic workplace culture and how to improve it, which can be found here. In the article, Heinz asserts that “going from toxic to healthy can improve employee morale, retention, and boost your company’s reputation.”

Five of the sixteen challenges cited are especially important to physician practices, because each of these areas can impact not only your team members, but also your patients.

1.Gossip

The first is a culture of gossip in your practice. Gossip is something that is a part of the personalities of many people, and is a learned behavior from childhood that doesn’t end in the workplace. The challenge at a physician practice is that gossip among employees, besides being hurtful and often untrue, dividing your team, and building distrust, can also reach your patients, which is an even bigger problem. The solution is a simple, but difficult one - address the problem head on by coaching individuals who are gossiping, and reinforce your practice policy at all hands meetings.

2. High Turnover Rate

Second is a high turnover rate at your practice. If you are one of those clinics with a stable clinical and support team who have been with your practice for years, consider yourself fortunate. Especially in large, urban or suburban clinics, turnover can be a challenge. One of the issues with turnover is that the assumption can be made that money is the only driver of a high turnover rate, when over 30 percent of workers who left a job in the first 90 days cited that the culture was not as expected. A solution to this challenge comes from within - by talking to your employees, both those who are leaving and your long-term employees. When an employee leaves, instead of doing the typical “exit interview,” ask some open-ended questions of employees to seek out how you can improve. With longer term employees, seek out their feedback about what is keeping them in their roles.

3. No Breaks

A third challenge, which might sound simple or necessary, is an indicator of another, possibly larger issue. This challenge = when employees regularly work through lunch. When your staff works through lunch all the time, it either means they don’t think they have enough time to complete all they need to do without working through lunch or they have seen this behavior modeled and fear reprisal if they don’t do the same. Especially in the physician office, where lunches are often provided by others, the expectation to breeze through the break room, grab whatever is available, and immediately get back to work. The solution to this is for practice leadership and physicians to model actually taking a lunch break. If you’re automatically doubting that this can be done, realize that it might take time and a shift, but multiple studies have shown that employees, even clinicians, are more productive when they take an actual lunch break. 

4. Bad Online Reviews

Next is employees leaving bad reviews of your clinic online. Employees are given the cover of anonymity in leaving reviews on many review sites, and there is a major temptation of upset employees to leave a bad review. This obviously will drive your ratings and is visible to your patients. A solution to this challenge is to provide an anonymous suggestion box or feedback box for employees in the office, where you give regular attention to the feedback given internally before it gets to the point of the employee going online to vent. 

5. Siloed Teams

A final sign that your practice has a rotten culture is that your teams are siloed. In the physician practice, there is typically a hierarchical structure, with the physician and executive team at one end, nurses and clinicians, medical assistants, coders and clinical support team, lab technicians, administrative team members, and other staff. Often, there is no communication between these functional areas, which puts the team in a silo. Where this is somewhat natural and unavoidable, one way for practice leadership to minimize the disruption of a siloed office is to simply talk to all staff members regularly, and communicate practice goals, progress, and acknowledge the contributions of all team members.

While all of these five areas of your culture aren’t unique to physician practice, they each can have a unique impact on your practice. As a leader, you can model awareness so that your entire practice is aware of the culture, and foster a culture of success.