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Cover Stories | Feb 2024

Cultivate Your Best Practice Culture

Insights from a private practice owner.

Ophthalmology is a highly competitive specialty. Our private practice has built a competitive advantage in our community by concentrating on the five Ps: pace, position, potential, performance, and power (see the sidebar for definitions).1 Of these, a focus on position—specifically our practice culture—has differentiated our practice from others.

The Five Ps*

Pace The timing and intensity of a practice’s strategic action

Position Conveying a unique and appealing image to patients

Potential The provision of superior capabilities and resources

Performance Delivering and implementing superior actions and strategies

Power Creating a successful collective organization

*Adapted from Luke RD et al.1


A practice’s position and reputation extend beyond the clinical expertise of its surgeons and eye care professionals. Although state-of-the-art technology and exceptional medical knowledge are important, patients often notice a practice’s culture more than the technology it uses.

Leading with a positive attitude and gratitude is the first step to cultivating a strong practice culture. This approach has a ripple effect throughout the practice that resonates with staff and patients alike and helps create an environment where everyone feels valued and cared for.

Another way to nurture a positive practice culture is through small acts of kindness. It is crucial to express gratitude to staff members, including those in the billing department and at the front desk and others who may not regularly interact with physicians. For instance, we send out a weekly email to the entire practice that highlights positive comments about staff members submitted by colleagues and patients. This creates a continuous loop of recognition and appreciation.

Beyond verbal gratitude, we incorporate incentives such as surprise gift cards, regular holiday celebrations, and theme days such as “Wear Your Favorite Sports Team Jersey to Work.” These seemingly simple tactics have helped build a fun and enjoyable practice culture, which patients appreciate as much as staff.

Acts of appreciation require time and resources, but they also demonstrate that we value our staff, boost morale, foster a sense of community, create a collective sense of purpose and fulfillment, and contribute to the overall success of the practice.


Staff personalities can significantly influence practice culture. We hire for attitude and train for skill. A candidate with a positive outlook is always preferred over one with prior eye care or medical experience but a poor attitude. This approach has proven to promote a positive practice culture and enhance staff satisfaction and engagement.

Some of our employees, particularly technicians, are between college and medical school. Although their time with us may be limited, their great attitudes and eagerness make training them worth the investment because they contribute positively to our practice culture.

We also emphasize diversity and inclusion to create a welcoming culture for both staff and patients. We celebrate our differences and are committed to maintaining an inclusive and accepting environment.

Conflict is inevitable in any practice. When it arises, we assume good intent and strive to align staff with the common purpose of resolving conflicts to provide quality care. Simon Sinek’s book Start With Why serves as a compass for our practice.2 We begin every conflict resolution conversation by asking the following questions: (1) Why are we here? and (2) What are we trying to accomplish? Not every conflict can be resolved, but most dissipate when addressed with a positive attitude from the start.


In the competitive field of ophthalmology, emphasizing a supportive and nurturing practice culture has been crucial to our success. We express gratitude, carefully consider staff personality, and embrace diversity, and inclusivity to optimize practice culture. The interconnectedness of these elements enhances the sustainability of our practice and creates a supportive environment for our staff and patients.

1. Luke RD, Begun JW, Walston SL. Strategy in health care organizations & markets. In: Health Care Management: Organizational Design and Behavior. Shortell S, Kaluzny A, eds. Delmar Publishers; 2000.

2. Sinek S. Start With Why : How Great Leaders Inspire Everyone to Take Action. Portfolio/Penguin; 2011.

John A. Hovanesian, MD
  • Private practice, Harvard Eye Associates, Laguna Hills, California
  • Clinical Instructor, Jules Stein Eye Institute, University of California, Los Angeles
  • Member, CRST Editorial Advisory Board
  • drhovanesian@harvardeye.com; X @DrHovanesian
  • Financial disclosure: None acknowledged
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