Skip to main content
  • Minimizing Culture Shock: Changing the Culture at Your New Practice or Institution

    Transitioning into a new practice or institution can be an exciting yet challenging experience for early-career ophthalmologists and eye surgeons.

    You’ve trained for years to diagnose, treat and surgically manage eye disease; however, the clinical management of eye conditions is only one facet of your job. The culture of a clinical practice plays a crucial role in shaping the work environment, your patients’ satisfaction and the professional satisfaction of yourself and your staff and, ultimately, the quality of care you can provide to your patients. 

    Culture shock can set in when you first walk through the door, but with these tips we can help you navigate the initial shock and help initiate positive changes in your clinical practice with the goal of enhancing the overall experience for both practitioners and patients.

    Understanding Culture Shock

    Culture shock is the disorientation and discomfort experienced when entering a new environment with unfamiliar customs, behaviors and expectations. Every clinical practice or institution has its unique culture, formed by a combination of the attitudes, values and practices of its physicians and employees. Recognizing and understanding the existing culture is the first step in making effective changes.

    1. Observe and Learn

    Upon joining a new practice or institution, take the time to observe and learn about the existing culture. Pay attention to how decisions are made, how communication flows and the overall atmosphere among colleagues and staff. Engage in open conversations with fellow ophthalmologists, practice leadership and staff to gain insights into their experiences and perspectives. 

    2. Identify Strengths and Areas for Improvement

    Evaluate the strengths and weaknesses of the existing culture. Identify practices or behaviors that contribute positively to patient care and professional growth, as well as areas that may require improvement. This assessment will help guide your efforts to bring about meaningful change.

    Your initial observations about workplace culture will likely be related to your individual practice. You’ll be working day in and day out with your ophthalmic technicians, operating room staff and front desk staff. You’ll also likely be discussing details of your practice style, surgical schedule and scheduling needs with practice managers or clinical leadership. 

    The existing culture usually dictates the dynamics of these interprofessional relationships. Identify areas where you and your team work well together, as well as areas that could be improved.  

    Initiating Change

    Implementing change in a clinical practice requires planning, effective communication and collaboration. Here are some strategies to consider:

    1. Lead by Example

    As an early-career ophthalmologist, you have the opportunity to lead by example and inspire change. Demonstrate professionalism, empathy and a commitment to excellence in patient care. Show up early, be detail-oriented and give positive, constructive feedback often to technicians and staff in a compassionate way. Model the behavior and values you believe are important for the practice to embody. 

    2. Communicate Effectively

    Open and transparent communication is vital in promoting a culture of collaboration and trust. Encourage regular team meetings to discuss challenges, share ideas and celebrate successes. Foster an environment where everyone feels comfortable expressing their opinions and concerns. 

    3. Foster a Learning Culture

    Promote continuous learning and professional development within the practice. Encourage colleagues to attend conferences, workshops and educational events. Facilitate regular knowledge-sharing sessions where ophthalmologists and surgeons can discuss interesting cases and exchange expertise. Help educate your staff about clinical findings that they’ll see or hear about when working up patients or answering patient phone calls. 

    Being able to model a curious and inquisitive mindset, an openness for learning and a desire to improve everyone’s skills will help instill a similar mindset in others. It will also make it easier for your colleagues and employees to ask questions without fear of speaking up.

    4. Embrace Technology

    Incorporating technology into clinical practices can streamline workflows, enhance patient care and improve efficiency. Any practice you join will likely already have an established electronic health record (EHR) system. However, you may look to create improvements to the EHR through tools like dot phrases (a "dot phrase" is something you can use to automatically bring up preprogrammed text) or note templates for yourself and your staff. 

    Additionally, you could reevaluate the workflow for ophthalmic testing and imaging, improve or upgrade existing digital tools or even implement telemedicine platforms to help turn patient phone calls into billable clinical encounters.

    5. Prioritize Work-Life Balance

    Recognize the importance of work-life balance and advocate for it within the practice. Encourage reasonable work hours, provide support for personal and family commitments and foster an environment where self-care is prioritized. Happy and well-rested employees are more likely to deliver exceptional patient care. 

    Overcoming Challenges

    Bringing about a change in the culture of a clinical practice can be challenging. Here are some common hurdles and strategies to overcome them.

    1. Resistance to Change

    Some colleagues or staff members may resist change due to fear of the unknown or a perceived threat to their well-established routines. Indeed, change is hard, and not everyone is as open to change as you might be. 

    Clearly communicate the rationale behind the proposed changes, emphasizing the benefits for both patients and staff and providing support and training to facilitate the transition. Importantly, listen to the concerns of your staff.

    2. Time Constraints

    The demanding nature of clinical practice can make it challenging to allocate time for culture change initiatives. Start small by identifying manageable projects or improvements that can be implemented gradually. Remember to engage colleagues and staff members in the process.

    3. Show That It’s Working

    Whenever possible, try to find metrics that you can track to show that any culture change initiative you implement is having a positive impact. Measure the metric at baseline and again a few months later to see if you’re making a difference. Metrics may include patient wait times, patient satisfaction scores, patient throughput or team member satisfaction.

    4. Building Consensus

    Seek input from colleagues and staff members, encouraging them to participate in decision-making processes. Building consensus among the team will foster a sense of ownership and increase the likelihood of successful implementation.

    Grayson W. Armstrong, MD, MPH About the author: Grayson W. Armstrong, MD, MPH, is a complex cataract surgeon, medical retina specialist,  and Director of Ophthalmic Emergency Services at Massachusetts Eye and Ear in Boston. He joined the YO Info Editorial Board in 2022.