Recognition, reward, communication: Establishing a practice culture

Amanda Lyons

28/05/2019 3:01:01 PM

Dr Sarah Lewis has found creating and maintaining a positive culture takes thought, hard work and the occasional tough conversation.

Practice culture.
Building and maintaining a good practice culture takes communication and hard work.

‘Family, teamwork, clinical excellence.’
These are the values at the heart of Port Melbourne Medical’s practice culture, according to Dr Sarah Lewis, a GP and member of the RACGP Victoria Council, who launched the practice in 2013.
However, the journey to those values has not necessarily been a simple one; it has taken time and experience to reach this level of clarity. Although Dr Lewis assumed her values would organically permeate her practice, she came to learn the process takes conscious effort and not a small amount of hard work.
‘At the beginning, I thought that because I had good intentions and knew what I wanted, other people would just naturally jump on board,’ she told newsGP.
‘However, not everyone thinks the same as me, and as we’ve grown I’ve realised how hard you have to work on culture.
‘You can’t have 15 fish swimming in one direction and one going the other way, upsetting it for everybody.’
Dr Lewis believes creating a good practice culture is vital in providing a satisfying workplace for all members of staff.
‘We spend so much time at work, it has to be a place we enjoy being, where we feel reward for our work,’ she said. ‘Financial reward, but also internal reward, knowing that we’ve done a good job.’
With the hindsight of her own experience, Dr Lewis now advises practice owners to actively consider what they want for their culture at an early stage.
‘Work out your values from the very start,’ she said.
‘What is important to you? How do you want your staff to behave? How do you want your doctors to behave?’
Once these key values have been identified, the next step is communication.
‘You need to work with your staff to make sure they understand those values, because they’re not mind-readers. They’re not going know what you’re thinking and what you’d like to achieve,’ Dr Lewis said.
‘Communicate this right from the outset, even from the stage of interviewing, just to make sure you’re all on the same page with your goals, because you’re not necessarily going to be aligned.’

Dr Sarah Lewis has learnt how to build a satisfying and positive practice culture while running her own practice over the past six years.

Dr Lewis has found leadership is key in establishing and maintaining a positive culture.
‘The active part of culture is leading by example. The leaders of the practice, whether that’s the owners, the principal doctors or the management staff, play a huge role in setting the tone of the clinic,’ Dr Lewis said.
‘And all the staff know when the management are doing things either for the good or not for the good of the clinic.
‘So, for example, to meet our standard of teamwork, all of our staff know they can always approach anyone at any time. That might be the doctors knowing they can ask me or other doctors clinical questions, or the nursing staff knowing they can come and ask advice about a patient they’re seeing. It’s also reception asking general advice about what they can do.
‘It’s about making sure we’re always approachable.’
Leadership also involves identifying the behaviours and values you do not want to allow within your practice culture.
‘For example, staff, particularly management staff, talking badly of other staff outside of a private meeting with specific concerns,’ Dr Lewis said.
‘That needs to be put a stop to straight away, because it’s a very quick way to make people feel unhappy and to make the workplace toxic.
‘Dealing with it also shows what is tolerated within the practice and what is not.’
Tackling staffing behavioural issues necessitates some tough conversations, a task Dr Lewis found difficult in her early years as an owner.
‘It is quite hard to have to discipline staff, especially at the start, because there is a fear you might lose them. And when you’re a very small team, losing one player is a very scary thought,’ she said. ‘But you have to have the uncomfortable conversations in order to maintain standards.
‘There’s ways you can have those conversations that aren’t degrading or upsetting. You can explain, “These are our values, we like to make sure that things are done at a level of excellence”, or, “We like to do things with a certain ethical approach”.’
Conversely, it is also important to recognise when people have upheld practice standards.
‘Working on practice culture also involves making sure we thank our staff and reward them when they’ve done a good job,’ Dr Lewis said. ‘Complimenting them on their ability to deal with a difficult case, or for maintaining a friendly face at reception even when there’s 10 people lined up, or they are dealing with a frustrated patient or a complaint.
‘We constantly encourage our staff in that regard.’
Once a practice culture has been firmly established, it can find its own momentum, and its own rewards.
‘We had two doctors join us recently and one doctor said, “Wow, all the doctors here do such a good job, it makes me want to lift my standards”. And the other doctor said, “I really need to improve my notes because I can see how everyone does it here”,’ Dr Lewis said.
‘It was really nice to hear, that all that hard work and selective recruiting paid off.’

Practice culture Practice management Practice ownership

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