The team members of Dr. Christina Kulesa's Northstar Family Dental office in Westerville, Ohio, show their enthusiasm for their practice.

Culture: The ultimate competitive advantage

March 1, 2021
What is office culture, why is it important, and how can you develop a culture? It will set your office apart from the others, and patients will notice the happy team and superior care.
Jay Geier, Founder, Scheduling Institute

Editor’s note: This is part one in a two-part article about culture in the dental office. Part two will appear in the April issue of Dental Economics.

Doctors graduate dental school with little training in business skills, so it’s no surprise they come out of school with little understanding of organizational culture and why it’s important. Yet, the day a dentist opens or buys a practice, he or she suddenly has a culture without even realizing it. In other words, every organization has a culture, by default. You can either live with the consequences of a default culture, which tends to be a pretty lousy one, or you can intentionally create the culture that you want.Why should you want a better culture? In this two-part article, I will first address what culture is and why it’s so important to the success and growth of your practice. In part two next month, I’ll share specific how-tos for defining, creating, and nurturing a culture that’s good for your team, your patients, and your business.

What is culture and why is it so important?

An organization’s culture incorporates its values, expected behaviors, and ways of working. The culture of a practice is reflected in the attitudes, mood, and motivations of everyone on the team, including you. Culture makes a person feel a certain way, for example:

Within minutes of walking into your office or speaking with someone on the phone, a patient develops a feeling about your business.
What your people say about you and their jobs when you aren’t around reflects how they feel about you and working for you. Think of all of the movies and comedians who make fun of bosses and work environments. Could you be one of those? Or do you recruit and retain top talent because they feel good about their jobs and working for you?

All of this may seem warm and fuzzy and too much about feelings. But don’t make the mistake of thinking culture does not have a direct impact on your bottom line. In a nutshell, a great culture is the ultimate competitive advantage. It’s what sets you apart, and it can’t be duplicated because it’s your unique way of running your office, leading your team, and serving your patients. 

A great culture will engage people in their work, retain and attract top talent, and impress patients, which leads to referrals and attracts new patients. A great culture, combined with outstanding leadership, will unlock the highest potential of the individuals who work for you and the business overall. 

A default culture is none of those things, and yet that’s what you have if you don’t intentionally set it to something else. We coach our clients to create a “high-performing, patient-centric, growth-oriented culture.” This incorporates the three crucial elements of a successful practice: (1) a well-trained team that’s capable and accountable of performing at a high level, (2) commitment to delivering an excellent patient experience down to the smallest detail, and (3) a growth mindset in order to help more patients, develop more team members, and better serve the community.

A great culture is especially important now as many doctors must recruit new team members to replace the ones they lost last year, and they need to focus on retaining the top talent they still have. Research reported by Mark Miller in his book Talent Magnet says the best and most talented people in the workforce today want three things1: (1) a better boss, (2) a brighter future; to be stretched, trained and developed, and given growth opportunities, and (3) to be part of a bigger vision; to do meaningful work that contributes to the world around them.

Note that compensation is not listed in the top three; these are all culture-oriented desires. This data blows the myth many doctors believe that they will train people and then those people will leave. Just the opposite is true; investing in training and development is part of a great culture that makes people want to stay.

How good is your culture?

As intangible as culture may seem, it can actually be measured. For example, what is your referral rate? We know from working with thousands of practices that those who follow our process for creating high-performing, patient-centric cultures enjoy referral rates of at least 50%. If yours is less than 50%, that’s a revealing and reliable measure that tells you your culture needs to improve.

When you say you want to do something, you want to propose a new idea or process to the team, does it get implemented? Your culture reflects the level of trust your people have in you. If they roll their eyes whenever you suggest a new way of doing things, it’s because they don’t trust you to follow through; they know nothing will change because it never does. New ideas are quickly absorbed within a great culture; people run with the ball, confident you’ll do what you say you will, and that you’ll support their efforts to execute. 

Intentionally create the culture you want

Learning to build a great culture is a trainable skill. Even if you don’t have a warm and fuzzy bone in your body, you can learn to create a culture that fosters employee engagement and accountability, teamwork, relentless focus on the patient experience, and a shared commitment to practice growth goals, which are all essential elements of a thriving practice. 

Stay tuned next month for specific how-to steps of a proven process that will generate bottom line results.  


1. Miller M. Talent Magnet: How to Attract and Keep the Best People. Berrett-Koehler; 2018.

JAY GEIER is an authority on growing independent practices to keep for a lifetime of revenue or sell for maximum value. He is the founder and CEO of Scheduling Institute, a firm that specializes in team training and doctor coaching to help people live up to their full potential and uncover the blind spots that are holding them back from that potential. To find out if your practice suffers from blind spots that could be killing your practice culture, go to to request your complimentary analysis.

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