When it comes to your company, there is no greater asset than a healthy team culture. As it has been said many times, “Team culture eats company strategy for breakfast.” You can have the best strategy, the strongest marketing, and the greatest profitability. However, if you do not also have a healthy team culture, your long-term success is doomed to failure.
It takes a lot of work, effort, and deliberate nurturing to develop and maintain a healthy team culture. Just like your reputation, it can take years to build and very little time to destroy. Here are the top 5 killers of team culture that leaders need to avoid.
1. Weak Leadership
As a physician, you are in a position of leadership and influence. Your team members look to you for wisdom and guidance. When you are not strong, and when you do not stand up for your team members, they stop trusting you. That is a recipe for a critical failure. Organizations move at the speed of trust. If you do not have your team members’ trust and respect, it is just a matter of time before people start leaving.
When I left my last job, I had people tell me how much they appreciated that I always had their backs. I have told my team many times, “If you do the right thing, I will always back you up.” I have a great team, and I trust them. So, when another physician or leader comes to me with a perceived problem about one of my team members, I have no problem standing up for them.
As a leader, you need to have your employees’ backs, and you must enforce the rules. I recall an incident where a Certified Registered Nurse Anesthetist made some very crude remarks in front of my team and a patient. I put a stop to it immediately, had some frank conversations with his department head, and he was fired shortly thereafter. Taking a stand like that built tremendous trust within my team.
We do not tolerate unprofessional behavior. Our team requires and expects excellence in all things. People trust that, and so our culture coalesces around a belief in being excellent.
Gossip is like a cancer in an organization, and it is one of the most pervasive killers of culture that I can think of. I tell my team members that complaints should always go up the chain of command, not laterally. Complaints that go up are issues that we can address and remedy. Complaints that go laterally are just gossip.
I do not like to engage in gossip, and I look for opportunities to quash it when I see it. Some organizations actually go so far as to have a “no-gossip” policy written into their employees’ contracts. You may think that is an extreme approach, and maybe it is. Gossip is normal, but so is team dysfunction. I am not always a fan of “normal.”
As a leader, you have the ability—and frankly the responsibility—to discourage gossip in your practice. It starts with you, as the leader, avoiding gossip. If your team members hear you gossiping, then they will naturally assume it is ok for them to engage in this behavior as well. However, that is not enough. You need to identify gossip and call it out when you see it. If you do this often enough, your team members will start policing themselves.
I have had new team members who began gossiping about something only to have an older team member say, “That sounds like gossip, and we do not do that on our team.” Wouldn’t it be amazing to hear that from one of your team members?
3. Lack of Clear Vision
Your team will not know where your organization is going if you do not tell them, and you should tell them often. A vision that no one knows or acts on is just a dream. Where there is no vision, the people perish.
You must set the tone and vision for the practice’s future. I strongly recommend you do this with input from your team members, but it is ultimately up to you as the leader. What is your plan for the future? Where do you see the practice in the next 5 to 10 years?
When your team members feel as though there is a future for them in the organization, they will be willing to contribute a lot more. That attitude will become infectious and will lead to a healthier team culture.
Your vision statement should not be a wish list. It should be specific, with a defined set of goals for your practice’s future. It should be memorable and actionable. Discuss it with your team often and explain why the vision is so important. Celebrate when someone is seen upholding the values inherent in the practice’s vision in a meaningful way.
Do not be like the leader who saw his followers going somewhere and said, “I must find out where my people are going so I can lead them there.” Take the lead. Be strong and have a clear vision that you articulate to your team.
4. Celebrating People Instead of Values
This is a subtle but key distinction in your interaction with team members that can shape your culture immensely. When you celebrate your team members, celebrate how they embody your organization’s values, not just their personal accomplishments.
For example, many people say, “Sarah is a superstar. We are so impressed by her accomplishments. She is in a class by herself.” The problem with this approach is that when Sarah leaves the organization, there is a psychological loss in the minds of your team members. They think of Sarah as incredibly valuable and perceive that she is taking that value with her when she leaves. As a result, your employees may see the team as being less valuable.
There is nothing wrong with celebrating your employees. In fact, I highly encourage it. However, a better way to do this is to celebrate how their attitudes and accomplishments reflect your overall team culture.
Here is a better way to celebrate Sarah. You can say, “Sarah is amazing. In our organization, one of our core values is selfless service. Sarah has been modeling that core value this month through her exceptional interactions with some very difficult patients. Through her selfless service, our patients are having a better experience here, and we want to celebrate that. We are proud that she has taken on the responsibility of promoting selfless service in a truly exceptional way.”
The difference is subtle. In the second example, you celebrate the value, not just the team member. If you do that, it will not be a psychological loss to the team if Sarah leaves. She is leaving, but she is not taking her accomplishments away from the practice. Instead, she is taking the practice’s values and going off to make the world a better place. In your team members’ minds, you are not losing Sarah, you are sending Sarah.
5. Failure to Keep Only the Right People
No one likes to think about having to fire people, but as a leader, it is imperative that you think about it often. Your practice is only as strong as your team members. If you have just 1 or 2 employees who are toxic, it will kill your team culture over time. Even if you have a few people who are not toxic but who just are not motivated to give more than minimum effort, you will struggle to retain top talent.
People have choices when it comes to employment. The best people have a lot of choices, so you need to give them a reason to stay. As a leader, you must not hesitate to fire employees who are not a significant benefit to the organization. You do not want a team of second-rate employees. If you have that, you will never be anything but second-rate.
But failure to fire bad team members has a much bigger consequence. Over time, you will lose your best people. When you fail to fire those who are just not getting the job done, you sanction their mediocrity. Others begin to believe that minimal effort and mediocre outcomes are acceptable. You will develop a team that accepts a reversion to the mean as the standard. Your best team members will not want to work in a place where their hard work and top accomplishments are not valued. The best people have choices, and they will choose to leave.
Therefore, it is imperative to be proactive and take action. Have the tough conversations with your team members. Set high expectations, and then hold people to those standards. When employees do not meet those expectations, let them go. Fill your team with only the best people, and your team will be the best.
Team culture is not something you take out of a box and it is ready to go. It takes time, nurturing, and careful attention to detail. It is not like putting a hammer to a nail. It is more like planting a field of crops. You need to till the soil, plant the seeds, remove weeds and pests, and water the crops on a regular basis. Eventually, over time, there will be a rich harvest.
Your team’s culture will make or break your practice. It is not about having the best vacation policy or the coolest ergonomic office designs. It is about the values you celebrate, the investment you make in your employees, and the strength of your leadership. You may not notice the difference immediately, but if you do not take steps to develop a healthy team culture, you will reap only disaster.
Brent W. Lacey, MD, is a gastroenterologist and Founder of The Scope of Practice (TheScopeOfPractice.com), a website and podcast devoted to helping physicians and other healthcare professionals learn to manage their businesses successfully and master their personal finances. He can be reached at