Practice Culture: What it is, where it comes from and why it’s important

Companies (like veterinary practices) are cultures.

Most of what is truly unique about humans can be summed up in one word: ‘Culture’. And culture is a powerful force. It speaks to a very basic human need that is driven by our fundamental instinct to survive – the need to belong. It determines our way of life.

Cultures are formed when people come together around a common set of values and beliefs. It’s because of our ability to form cultures that we succeeded as a species. But not all cultures are successful. When cultures add up to be greater than the sum of their parts, they thrive. When they add up to be less, they don’t.

Companies (like veterinary practices) are cultures.

Companies are fundamentally nothing more than organized groups of people with a particular purpose, brought together around a common set of values and beliefs. Companies (like veterinary practices) are cultures. And no different to any other culture, they’re either successful or not. 

There are probably as many definitions of practice culture as there are consultants who advise on it. But that it exists and that it plays a crucial role in shaping the behaviour in your practice is universally agreed. 

...a rulebook that lives in the minds of employees...

When talking about practice culture, I prefer to use the analogy of a rulebook that lives in the minds of employees and guides how they behave around others in the workplace. Together, these mental rulebooks make up the real or lived culture of the practice. When the mental rulebooks of the employees are very similar, the practice has a strong culture. But when they are not, the culture is weak. Similarly, when the rules that make up the practice culture engender a highly engaged, productive and satisfied team, the practice has a healthy or good culture. But when they don’t, the culture is perceived as unhealthy, bad, or even toxic.    

Every practice of course also has an aspirational or ideal culture. Here the rulebook lives in the minds of practice owners or leaders and is reflected in the mission statement, values, and ideals. When the real culture and the aspirational culture align, you’ve achieved the (near impossible) equivalent of practice culture nirvana. But most leaders agree that a disconnect exists between real culture and aspirational culture. The stronger the real culture and wider the gap, the more difficult (sometimes, unfortunately, near impossible) it is to fix. 

But where do the rules that make up the mental rulebooks come from...?

But where do the rules that make up the mental rulebooks come from, and how are these rules propagated among the members of your team? This too is better explained using an analogy, this time borrowed from the book The Selfish Gene by the British evolutionary biologist Richard Dawkins first published in 1976. Here Dawkins suggests that culture is composed of memes which he defined as ‘units of imitation and replication’ or simply units of cultural transmission. Memes are the rules that make up the rule book that lives in the minds of the people who make up the culture. Leaping from body to body as they do, genes replicate and disseminate in a gene pool. But memes do so by leaping from mind to mind in a meme pool.

Within practice culture, these memes - the rules that make up the mental rule book - can take a variety of forms. Like the language we choose to use when speaking to people, for example. Or how people choose to behave or dress, and so on. They help us understand ‘how things get done around here.’ What we should do and how we should react in any given situation. It defines what is encouraged, discouraged, accepted, or rejected within the practice team. Therefore, culture is not who you are, it’s what you do. 

Culture compels those who are aligned with it, helping them to thrive, and repels those who aren’t, driving them out.

The practice culture, be it good or bad, is propagated when team members copy and add these behavioural memes they observe or experience to their own mental rule book. Those memes that are most successful in being copied and transmitted become the most prevalent within a culture. Culture compels those who are aligned with it, helping them to thrive, and repels those who aren’t, driving them out. Leaving the real culture to be reinforced by those who remain. 

So why does any of this matter? Why should you care? 

Firstly, you have a practice culture whether you’re intentional about or not. And it’s a powerful force because it is self-perpetuating. No matter whether your culture is good or bad, or the gap between the real and aspirational culture is wide, it can only change if enough people start behaving differently and a new norm is established. A feat that is decidedly difficult to accomplish. 

Secondly, a strong practice culture can significantly hamper any change in strategic direction when it requires a change in values and behaviours. For example, when consolidators acquire independent veterinary hospitals, and more emphasis is placed on generating revenue and profitability. Or when practice owners want to cultivate a culture of teamwork and collaboration, but reward veterinarians based on their individual billing. 

Thirdly, a healthy practice culture means team members are more engaged and satisfied with their job. And satisfied employees are more loyal and productive, which in turn reduces churn, improves business outcomes and propels company growth. 

It differentiates you from the competition and turns your employees into advocates.

And finally, perception is everything and it is your practice culture that feeds the perception of your employer brand. When it comes to recruiting, a strong employer brand does most of the heavy lifting for you. It differentiates you from the competition and turns your employees into advocates. In fact, it gets you twice as many applicants, in half the time, at half the cost when compared to companies that don’t have a strong employer brand. 

Defining practice culture is as complex as its impact on practice performance is powerful. It emerges from the interactions between people and the workplace environment. It cannot be changed by decree, but it’s enforced and perpetuated by the attitudes and behaviours you recruit, hire, reward and promote.

It isn’t what you say it is. It’s what you do.