The expression “Culture eats strategy for breakfast” may be applied to running an ophthalmology practice. The phrase was coined by management consultant and writer Peter Drucker and was made famous by Mark Fields, former president and CEO of Ford Motor Company.1 A positive practice culture gives staff members a sense of identity and pride in what they do. No matter how effective your business strategy is, your practice will not be successful if it lacks the right culture. (Editor’s note: For more on culture in the workplace, see CRST Europe’s May 2019 issue.)
Of course, you first must determine what the ideal culture for your practice is. The next challenge is to create it. A number of models have been developed to help practices map out a culture, but one of the most effective solutions is called the Cultural Web. Developed by UK academicians Johnson and Scholes,2 the Cultural Web breaks organizational culture down into six elements:
No. 1: Stories. How does your practice understand and describe itself? Stories encompass what staff members tell each other and external people about the practice. These stories may be shared in the lunchroom, hallways, or exam room, and they often describe the heroes, successes, and failures of the practice. Stories reveal a lot about the values present in your practice.
No. 2: Rituals and routines. What are the daily behaviors of your staff, and do they align with the expectations of the practice leadership? Rituals may include drinks after work, employee-of-the-month celebrations, and training courses, for example.
No. 3: Symbols. How is your practice represented, such as by logos, furniture in the waiting area, and the dress code of your staff?
No. 4: Control systems. Financial systems, rewards, and quality controls highlight the crucial processes and values of your practice.
No. 5: Organizational structure. How people from different parts of your practice relate to each other reveals your practice’s unspoken hierarchy.
No. 6: Power structure. The upper level of an organizational structure has one or two key staff members (such as the physician CEO) who wield the most influence on your practice’s decisions and strategic direction.
You can use these ideas to understand and fine-tune your practice culture. Doing so can affect practice performance and strategy.
Erik L. Mertens, MD, FEBOphth
Chief Medical Editor
1. Coffman C, Sorensen K. Culture Eats Strategy for Lunch: The Secret of Extraordinary Results, Igniting the Passion Within. Denver, CO: Liang Addison Press; 2013.
2. Johnson G, Scholes K, Whittington R. Exploring Corporate Strategy. 8th ed. Upper Saddle River, NJ: Prentice Hall; 2008.
