We noticed you’re blocking ads

Thanks for visiting CRSTG | Europe Edition. Our advertisers are important supporters of this site, and content cannot be accessed if ad-blocking software is activated.

In order to avoid adverse performance issues with this site, please white list https://crstodayeurope.com in your ad blocker then refresh this page.

Need help? Click here for instructions.

Editorial Spotlight | May 2019

The Best Things in Life Are Free, and so Is Company Culture

Improve your practice by demonstrating the behavior that’s right for you and your employees.

You may be familiar with the saying by management consultant Peter Drucker, “Culture eats strategy for breakfast.” We think that culture has an even greater appetite; it has strategy for lunch, dinner, and a snack. Why is it more important to spend time creating a workplace environment that meets employees’ needs than just to worry all the time about patient numbers and strategy? Because your employees can make or break your practice.

Company culture is always happening. It happens when we are not even thinking about it, just as it happens when we make costly changes and hire consultants to try to improve practice culture consciously. In either case, the result may or may not work well for your workforce.

Company culture is a delicate topic, and it carries incredible potential for any business. Doctors and their practices are no exception. In the 21st century—a time when people are no longer just satisfied with having a job—culture is the one thing that can help a company stand out. Younger people, especially, tend to look for the job that makes them happy and gives them a better quality of life.

Salary matters, but culture matters more. Many people feel that happiness and job satisfaction have become entitlements. Nothing is more depressing than the thought of having to work until we are too old to start enjoying our one and only life. People who are engaged and happy at their workplace deliver better results than others, stick around longer, and, as a side benefit for every company, take fewer sick days during the year.

For medical practices, happy employees means happy patients, which in turn means a happy business.


The health care sector is a textbook example of the huge impact a company’s culture can have directly on human beings; people affect people directly. Our staff is our most precious capital, and it determines success or failure.

Today, we may think that our profession has no reason to worry about disengaged employees and attrition. We may expect that our staff members jump out of bed every morning to enthusiastically take on a day of saving sight. Isn’t this a beautiful profession, when we are able to help other humans, cure their diseases, and restore their vision?

Yes, it is.

And no, it is not.

Enthusiasm for work is like a tender plant that needs to be watered and nurtured daily. Look at the operation of a general hospital, with its mosaic of medical, entrepreneurial, emotional, and personal skills. Dealing with individuals, sick or recovering, who want to be healthy again puts everyone under extreme pressure. And we really mean everyone: the cleaning lady who mops the floors so that no one slips and breaks a neck; the nurse who disinfects surgical tools so that no one dies from an invisible bug; the chief resident who is an ace at cardiothoracic surgery; and the guy in accounting who makes sure that everyone gets a paycheck at the end of the month. They all play vital parts, and one cannot do his or her job without the others.

Nevertheless, strict hierarchies and a lack of appreciation regarding who does what may lead to disengagement and mistrust. Without proper motivation, no one will want to do more than necessary, to be responsible more than necessary, or to go above and beyond to cater to your customers—your patients.

In the long run, without motivation, people quit too soon, leaving a gap that is costly to fill. When employees resign, the first question their managers ask is: What is it that you want, more money? They forget that a few hundred euros will most likely not make up for poor management or unhealthy company culture where merit is left unrewarded. This is a common problem, and it hits the medical sector hard because doctors generally do not have adequate management skills.


So what makes a good company culture? There is no right or wrong answer, as long as the culture is defined clearly to all stakeholders and accepted by the entire team.

If everybody in your practice is motivated by being yelled at and never getting recognition for what they do, and they still work for you, without complaining, for 35 years, don’t change a thing—you are successful with that management strategy. From experience, however, we know that nine out of 10 employees would not be enthusiastic about such a workplace. In the accompanying sidebar are six straightforward tips for improving your practice’s company culture for the better.

Tips for Improving Company Culture

No. 1: Walk the walk, and listen before you talk.

Be authentic and credible. If you want your people to be happy at work, show that you are on a mission. See the person behind your employee who has a family, a dog, and sometimes a bad day. One person comes with a million emotions that make him or her unique.

People put on their work hats when they start their shifts, but they never take off their personalities. Listen to what people have to say, and don’t interrupt with questions. Sometimes people just want to blow off steam; they are not looking for an interrogation.

No. 2: Communicate.

Communication is the most undervalued tool in the universe. Sharing knowledge at work makes everyone feel involved, valued, and important. If you keep secrets, avoid controversy, and implement new policies without discussing the changes with employees beforehand, they will begin to develop skepticism for anything you propose.

No. 3: Encourage people to live your values.

In a previous article for CRST Europe (What is Your Scale of Values?, May 2016; http://bit.ly/Riha0519), I (WR) and my coauthor Harry M. Jansen Kraemer Jr explained that a set of values is a must-have for any company. Values must be lived and demonstrated from the top down in order to have an effect on employees. If you come in wearing sneakers and shorts, don’t expect your staff to come to work in a tie and suit. You will lose credibility.

Try delicately nudging your employees to live your values rather than attempting the impossible task of changing the way they think. Showing them examples can trigger small culture-shaping shifts. Think of it as performing role-playing in order to illustrate what your values are. In this way, your values will become part of how your staff members think. Remember, culture evolves. It can’t be installed, but it can be instilled. Be patient and persistent because it takes time.

No. 4: For heaven’s sake, say, “Thank you!”

Recognition is the world’s easiest and cheapest recruitment and retention tool. It’s not rocket science (although it is good neuroscience) to express gratitude to employees for their cooperation, for taking an extra shift, or for accepting a flexible approach toward holiday planning. The list of things people do for one another daily is endless. Just saying, “thank you,” and meaning it, will work miracles. Nothing oils the human machine better than recognition.

No. 5: Hand power over to employees.

In hierarchical structures, it’s common for those at the top to look down on those at the bottom. Employees in lower positions with lower salaries inherently feel inferior and intimidated. Make employees feel bigger by handing some power over to them. Ask for their opinions. Assign a small budget to each person on the team to spend on company matters without needing approval. Organize lunch and learn sessions at which people can talk about their responsibilities or even about hobbies they love. Give them a spotlight to feel appreciated and important, and they will shine brighter afterward.

No. 6: Give every individual room to bloom.

Lack of development is often a main reason that people change jobs. If you want to keep your staff members longer, invest in them. Offer training opportunities to improve hard or soft skills as part of your culture of recognition. Train employees so that they could leave tomorrow, but treat them so that they won’t want to.


You know what it feels like to go on vacation. When your destination sends out negative or hostile vibes, do you enjoy your stay? It may sound simplistic, but, at the end of the day, the same principles apply at your practice.

When your work culture is not employee-friendly, your employees are not enjoying their tasks. They can become resistant to what’s going on, to what the company wants to achieve, and—what’s worse in our profession—to what’s happening to your patients.

Creating and nurturing a company culture is a low-cost project. (Most of the things discussed here are absolutely free.) It does not cost you a penny to be a role model for behavior, by living the values that you deem important and by encouraging your employees to follow suit.

It’s up to you to be a star CEO in the medical field. Help your employees make their days at work count instead of just counting the days until they can retire.

Wolfgang Riha, MD
  • Physician CEO and refractive surgeon, Sehkraft Augenzentrum, Salzburg and Vienna, Austria
  • riha@dr-riha.com
  • Financial interest: None
Judith Schmuck
  • Head of Employee Engagement, GVC Group, London
  • hej@bjuty.at
  • Financial interest: None