How to Create a Winning Clinic Culture That Keeps Your Team Loyal and Engaged
Group culture is one of the most powerful forces on the planet.
We sense its presence inside successful businesses, championship teams, and thriving families, and we sense when it’s absent or toxic. When we look at these organizations, we tend to focus on the people immersed in the culture to gain insight. We focus on what we can see such as individual skills.
Individual skills, however, are not what matters. What matters is the interaction.
Culture is not something you are, rather culture is something you develop and build through a specific set of skills.
Here are 3 top culture skills:
- Skill 1—Build Safety: Signals of connection generate bonds of belonging and identity.
- Skill 2—Share Vulnerability: Habits of mutual risk drive trusting cooperation.
- Skill 3—Establish Purpose: Narratives create shared goals and values.
Over the past year, we have been working with a number of clinics, hospitals, and universities to develop their organizations' culture. Part of this work has been through Embodia's Private Academies where organizations can host their own online training, courses, and continuing education for their teams. I have had the opportunity to meet with the leaders of these organizations and get an insiders look at their strategies.
And now, they are going to share these lessons with you.
We are thrilled to announce that we have developed a brand new live training series in partnership with the Canadian Physiotherapy Association Private Practice Division & Rick Lau from CallHero where we will interview top clinic owners, leaders, and clinicians who are focused on developing world-class culture.
This new, free training series is for any clinic owner, leader, hospital administrator, executive, professor, researcher, or clinician who is interested in developing their team-building skills and building a supportive culture that motivates and inspires. Save your seat here (limited to the first 500 registrants only).
On the second episode of Clinic Culture Secrets, we are going to discuss and deconstruct growing a niche practice with Kyle Whaley, the owner of Propel Physiotherapy.
In this episode of Clinic Culture Secrets, you will learn:
✔ Kyle's top clinic culture tactics that keep employees (and clinicians) loyal & motivated
✔ How to reward and recognize your team during these challenging times
✔ Culture strategies to improve the mental health of your teams
✔ How to lead your teams when they are fearful and stressed out
✔ The do's and don'ts of onboarding your teams (front desk and clinician) so they remain loyal and never leave you for a higher paying job
Show up with questions, concerns, fears, and solutions! This is a safe learning space and you will have the opportunity to ask anything you like!
Now, let's take a deeper dive into each of the three skills.
Skill 1: Build Safety
Safety is the foundation on which a strong culture is built. Where does it come from and how do you go about building it?
People inside highly successful groups typically describe their relationship with one another using one word: Family. What’s more, like families, much of the communication is non-verbal – supportive belonging cues.
We humans have long used signals - even before language - and our "Belonging" cues possess three basic qualities:
- Energy: We invest in the exchange that is occurring.
- Individualization: We treat the person as unique and valued.
- Future orientation: We signal the relationship will continue.
These cues add up to a message that can be described with a single phrase: "You are safe here. You see me."
How to Build Belonging
A misconception about highly successful cultures is that they are happy, light-hearted places. Whilst they are energized and engaged, at their core their members are oriented less around achieving happiness than around solving hard problems together. This task involves many moments of high-candor feedback and uncomfortable truth-telling, when they confront the gap between where the group is, and where it ought to be.
Researchers have discovered that one form of feedback boosts effort and performance so immensely that they deemed it “magical feedback.”
Consider this simple phrase: "I’m giving you these comments because I have very high expectations and I know that you can reach them"
None of the words in this statement contain any information on how to improve. Yet, they are powerful because they deliver a burst of three belonging cues: You are part of this group. This group is special; we have high standards here. I believe you can reach those standards.
How to Design for Belonging
In an experiment, different engineering companies were given the same challenge, and observations were made of their working practices. What transpired was that the most successful projects were those driven by sets of individuals who formed “clusters of high communicators.”
Did they possess the same levels of intelligence? Had they attended the same undergraduate schools or achieved the same level of degrees? Did they possess the most experience or the best leadership skills?
Only one factor seemed to play a meaningful role in cohesion - the distance between their desks.
What mattered most in creating a successful team had less to do with intelligence and experience, and more to do with where the desks happened to be located. Closeness helped create efficiencies of connection.
Now, during COVID-19 physical closeness may not be an option. However, we can get creative and think of other ways to facilitate closeness. One way that organizations have facilitated closeness is through Embodia's Private Academies, which allows them to host their own internal team training, on-boarding, and mentorship so that all team members feel supported.
Ideas for Action
Building safety requires you to recognize patterns, react quickly, and deliver the right signal at the right time.
Overcommunicate Your Listening:
It looks like this - head tilted slightly forward, eyes unblinking, and eyebrows arched up. Body still, leaning toward the speaker with intent.
Spotlight Your Fallibility Early On: Especially If You’re a Leader: Open up, show you make mistakes, and invite input with simple phrases like “This is just my two cents.” “Of course, I could be wrong here.” “What am I missing?” “What do you think?”
Embrace the Messenger: One of the most vital moments for creating safety is when a group shares bad news or gives tough feedback. Don’t shoot the messenger, you have to hug the messenger and let them know how much you need that feedback. By doing so, you can be sure they feel safe enough to tell you the truth next time.
Overdo Thank-Yous: Thank-yous aren’t the only expressions of gratitude. They are crucial belonging cues that generate a contagious sense of safety, connection, and motivation.
Capitalize on Threshold Moments: When we enter a new group, our brains decide quickly whether or not to connect. As such, successful cultures treat these threshold moments as more important than any other.
Skill 2: Share Vulnerability
The question "Tell me what you want, and I’ll help you," can unlock a group’s ability to perform.
The key here involves a willingness to perform a certain behavior that goes against our every instinct - sharing vulnerability.
When you watch highly cohesive groups in action, you will see many moments of fluid, trusting cooperation. These moments often happen when the group is confronted with a tough obstacle. Without communication or planning, the group starts to move and think as one, finding its way through the obstacle as if they are all wired into the same brain.
The Vulnerability Loop
At some level, we intuitively know that vulnerability tends to spark cooperation and trust. People tend to think of vulnerability in a touchy-feely way, but that’s not what’s happening in successful groups. It’s about sending a clear signal that you have weaknesses and could use help. And, if that behavior becomes a model for others, then you can set the insecurities aside and get to work, start to trust each other and help one another.
The second person is the key.
Person A sends a signal of vulnerability. Person B detects this signal. Person B responds by signaling their own vulnerability. Person A detects this signal. A norm is established; and closeness and trust increase.
Vulnerability doesn’t come after trust—it precedes it. Leaping into the unknown, when done alongside others, causes the solid ground of trust to materialize beneath our feet. Being vulnerable gets the static out of the way and lets us do the job together, without worrying or hesitating. It lets us work as one unit.
Cooperation through being vulnerable together, does not simply descend out of the blue. It is a group muscle that is built according to a specific pattern of repeated interaction - a circle of people engaged in the risky, occasionally painful, ultimately rewarding process.
How to Create Cooperation with Individuals: The Nyquist Method
Harry Nyquist, a quiet Swedish Engineer in the Bell Labs, regularly ate lunch with Nyquist.
Nyquist possessed two important qualities. The first quality was warmth. Nyquist had a knack for making people feel cared for. The second quality was a relentless curiosity. In a landscape made-up of diverse scientific domains, he combined breadth and depth of knowledge with a desire to seek connections. Nyquist was full of ideas and full of questions. He could capture what someone was doing, throw some new ideas at them, and ask, ‘Why don’t you try that?”’
The most important moments in conversation happen when one person is actively and intently listening. It’s not an accident that concordance happens when there’s one person talking and the other person listening. It’s very hard to be empathic when you’re talking. Talking is really complicated, because you’re thinking and planning what you’re going to say, and you tend to get stuck in your own head. But not when you’re listening. When you’re really listening, you lose time. There’s no sense of yourself, because it’s not about you. It’s all about connecting completely to the other person.
Ideas for Action
Make Sure the Leader Is Vulnerable First and Often: In moments of vulnerability, none carries more power than the moment when a leader signals vulnerability.
Try the following:
When Forming New Groups, Focus on Two Critical Moments: The first vulnerability and the first disagreement. These small moments are doorways to two possible group paths: Are we about appearing strong or about exploring the landscape together? Are we about winning interactions, or about learning together?
At these moments, people either dig in, become defensive, start justifying, and a lot of tension gets created. Or, they say something like, ‘Hey, that’s interesting. Why don’t you agree? I might be wrong, and I’m curious and want to talk about it some more.’ What happens in that moment helps set the pattern for everything that follows.
- In Conversation, Resist the Temptation to Reflexively Add Value: The most important part of creating vulnerability often resides not in what you say, but in what you do not say. This means having the willpower to forgo easy opportunities to offer solutions and make suggestions. Skilled listeners do not interrupt with phrases such as, "Hey, here’s an idea...", or "Let me tell you what worked for me in a similar situation..." because they understand that it’s not about them.
- Align Language with Action: Many highly cooperative groups use language to reinforce their interdependence. For example, navy pilots returning to aircraft carriers do not “land,” but are “recovered.” IDEO doesn’t have “project managers”—it has “design community leaders.” Groups at Pixar do not offer “notes” on early versions of films; they “plus” them by offering solutions to problems. These might seem like small semantic differences, but they matter because they continually highlight the cooperative, interconnected nature of the work and reinforce the group’s shared identity.
- Be Occasionally Absent: The New Zealand All-Blacks rugby team have made a habit of this, as players lead several practice sessions each week with little input from the coaches. Coaches responded: “They were better at figuring out what they needed to do themselves than I could ever be.”
Skill 3: Establish Purpose
When you walk into SEAL headquarters at Dam Neck, Virginia, you pass a twisted girder from the World Trade Center bombing, a flag from Mogadishu, and so many memorials to fallen SEALs that it resembles a military museum.
Walking into Pixar’s headquarters feels like walking into one of its movies. From full-sized characters such as Toy Story's Woody and Buzz made of LEGOs to the twenty-foot-tall Luxo Lamp outside the entrance, everything gleams with Pixarian magic.
What’s more, the same focus exists within their language. Walking around these places, you tend to hear the same catchphrases and mottos delivered in the same rhythms. This is surprising since you could easily presume that Pixarians would not need to be reminded that technology inspires art, and art inspires technology or that the SEALs would not need to be reminded that it’s important to shoot, move, and communicate,
And yet that is what they do. These groups, who by all rights should know what they stand for, devote a surprising amount of time telling their own story, reminding each other precisely what they stand for—then repeating it ad infinitum.
Why? The purpose isn’t about tapping into some mystical internal drive, but rather about creating simple beacons that focus attention and engagement on the shared goal. Successful cultures do this by relentlessly seeking ways to tell and retell their story. To do this, they build high-purpose environments.
High-purpose environments are filled with small, vivid signals designed to create a link between the present moment and a future ideal. They provide the two simple locators that every navigation process requires: Here is where we are, and Here is where we want to go.
That shared future could be a goal or a behavior. It doesn’t matter. What matters is establishing this link and consistently creating engagement around it. What matters is telling the story. When we hear a story, however, our brain lights up, tracing the chains of cause, effect, and meaning. Stories are not just stories; they are the best invention ever created for delivering mental models that drive behavior.
High-purpose environments are about sending ultra-clear signals that are aligned with a shared goal. They are less about being inspiring than about being consistent. They are found not within big speeches so much as within everyday moments when people can sense the message: This is why we work; this is what we are aiming for.
How do you create one? The answer, it turns out, depends on the type of skills you want your group to perform. High-proficiency environments help a group deliver a well-defined, reliable performance, while high-creativity environments help a group create something new. This distinction is important because it highlights the two basic challenges facing any group: consistency and innovation.
How to Lead for Consistency
If you spend time around the New Zealand All-Blacks rugby team, you will hear them talk about “leaving the jersey in a better place,” and saying, “If you’re not growing anywhere, you’re not going anywhere,” keeping a “blue head” instead of a “red head” (which refers to calmness under pressure), “Pressure is a privilege,” “TQB—total quality ball,” “KBA—keep the ball alive,” “It’s an honor, not a job,” “Go for the gap,” and “Better people make better All-Blacks.” These types of trigger phrases can be created for your own organization and be used to generate the energy needed by a high-purpose environment.
How to Lead for Creativity
Creative leadership appears to be mysterious because we tend to regard creativity as a gift, as a quasi-magical ability to see things that do not yet exist and to invent them. Accordingly, we tend to think of creative leaders as artists. However, many leaders of successful creative cultures, aren't artists. Instead, they are a different type, a type who speaks quietly and tend to spend a lot of time observing, who have an introverted vibe and like to talk about systems and processes. Leaders understand that teams are in a better position to solve problems, and a suggestion from a powerful person tends to be followed. Consequently, they step aside to encourage creativity giving outline guidance and then stating “Now it’s up to you.”
I can't wait for you to join us for this very special free series. We will have an amazing discussion with Kyle Whaley on Friday, November 25 at 11 pm EST (8 am PST).
Space is limited to the first 500 registrants.
This brand new Clinic Culture Series in collaboration with Rick Lau, co-founder of CallHero, and the Private Practice Division of the Canadian Physiotherapy Association (CPA) will be live examples of clinics doing all of the above and more in the rehab industry. If you want to learn how all of this translates into actionable culture then the webinar series is for you! We are going to discuss tactics and strategies that you can implement right away with your team!