How to Scale Culture as Quickly as Your Practice Group Grows

With 60+ locations, it is no longer feasible for me to communicate the company’s values to every employee face-to-face or monitor culture in person.

I started my dermatology practice in 2010 as a single practitioner with just one office. Today, Schweiger Dermatology Group is the largest dermatology practice group in New York City, with more than 60 office locations and 200 providers in the Northeast. That kind of success is gratifying, but it comes with challenges.

One of our biggest challenges was to establish a consistent, well-defined culture as we began to scale. Sometime after we opened our 10th location, I realized that it was no longer feasible for me to communicate the company’s values to every employee face-to-face or monitor the culture in person. We needed to create a culture that could scale across our growing network of clinics and guide every employee to embody those values in their daily work.

Here is what the process looked like for us to create and scale company culture:

Step 1: Identify and formalize values

We needed to spend time as a company to explore the values that we believed helped us differentiate from our competitors and achieve success:

Read up

My first step was to read as many books with company culture examples and advice for how to scale culture as I could get my hands on. Before getting my staff involved, I wanted to familiarize myself with some of the ideas and approaches advocated by experts and top-performing companies.

Brainstorm

I set up a series of meetings with our company leaders—a group of 12 people in all. We started by brainstorming to identify the company’s goals, the values that we believed would help our company achieve those goals and the behaviors that embody those values in the workplace.

Refine

Next, we went through a process of refining the list until we had reduced it to a manageable shortlist of six core values. These are the values that we all agreed are essential to our company—its purpose, its continued growth, the customer experience and the employee experience.

Gather feedback

We wanted to be sure that these values reflected every employee’s experience, not just that of our leadership team, so our next step was to present these core values to a representative sample of our employees—a group of about 60 in all—to get their feedback and further refine the document.

It took us several months to finalize our values, but our value statements (listed below), along with a set of organizational priorities and behavioral guidelines, are now the roadmap that guides how we live and scale company culture across all 60 locations.

Step 2: Operationalize and scale company culture

We knew that our company culture couldn’t just be written down and filed away. It needed to reach every employee and shape the way we ran the business day to day. We have intentionally looked for ways to align our operations with our core values wherever possible:

Recruitment and acquisition

We created a series of interview questions designed to evaluate the cultural fit of candidates under consideration, and we have also created a set of criteria for evaluating staff at newly acquired clinics. We also re-evaluated our processes for integrating staff from newly acquired clinics. Rather than hiring the existing staff automatically, we now evaluate them as we would any prospective employee to ensure that they embody our company culture.

Employee orientation

Every employee receives a laminated desk card printed with our core values and the behaviors that support them. They also receive a copy of a book we produced that’s filled with stories of employees who did something that embodies a specific core value.

By giving real-life examples, we make our values tangible and show how employees are supporting our company culture day to day.

Recognition

“Applaud good work” is one of our core values, so employee recognition is a big part of our culture. We support it with everything from shout-outs for people who did a great job of representing our core values that day to more formal peer recognition, such as our “Star of the Quarter” program. Every quarter, employees can nominate four or five of their peers who embody one or more of the company’s core values, and nominees are rewarded with a gift certificate and a celebratory dinner with the whole team.

Strategic direction

Our core values are front and center in every decision we make about the company’s direction. Every quarter, we have a strategy session with our key employees that begins with a review of our core values so that we can evaluate everything that’s happening in the company in that context. Regardless of the opportunity or the decision point we have in front of us, we ask the same questions: “Will doing this help to create the ultimate patient experience or not?”

If it’s not adding value for the patient and it doesn’t align with our core values, why would we consider doing it?

Here’s the bottom line.

Companies with a well-defined culture have a greater chance of success. But high-growth businesses like healthcare practice groups need to scale company culture as quickly as they grow. By identifying our values through a formal, collaborative process and by baking them into our day-to-day operations, we have seen our culture grow stronger despite the pressures of rapid growth.

Company Culture Example: Schweiger’s Core Values Roadmap

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