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Jake Puhl, CEO of the Dentist Entrepreneur Organization (DEO) discusses the importance of developing the culture of your DSO for successful business growth.

If you talk to a dental group owner with 20 to 25 employees and talk to an owner with 100 employees, they both will say culture is the most important thing. It guides operations, aligns the team and patient experiences with your goals and values, and with intentional effort, you can create a culture where people want to work and patients want to come for their dental care.

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What is your company’s culture?

Some people say culture is the feeling you get when you walk into a room.  Some people say culture is reflected in the words that are communicate and how people speak to each other. Others say culture is made up of how people in the organization behave. Some would say it’s how you go about doing things in a standardized way.

I would say culture is the sum of an organization's attitudes, ideals, and attributes, which may not be expressly written but are communicated in words and observed in the operations of the business and behaviors of its employees.

If you don't know what your culture is, the first thing is to ask your team? Depending on your size, have meeting in which you share thoughts, interview employees at various levels, survey your employees, or a combination of these. You can bring in a consultant to facilitate this.

In our Dental Entrepreneur Organization (DEO), the Member Mastermind Groups talk about this at length, and our group facilitators help our members learn the principles of defining their culture and then building it. There are known methods and tools for formally discovering your culture. Our members learn about surveying and skip level interviews, which is where you might go as a CEO and interview somebody that's two levels below you. You can mine information also from 360 degree reviews and other types of assessments.

When you are in the process of finding out the status of your current culture, you must encourage open honesty.

You want to know your employee’s thoughts and even anecdotal experiences about:

  • What is it like to work here?
  • What do you think we're all about?
  • What do you perceive are the values of our company?
  • What do we do here that is distinctive?
  • What is it like to be a patient here?

With honest feedback, you can intentionally affirm and communicate the attitudes, values, and related behaviors that are most important as you align your team and systems with your visionfor what you want your company to represent and how you want its members to behave in relationship with each other and with patients. You will discover gaps between what you envision for the company and what exists now. Knowing these shortcomings, you can go about intentionally improving the culture.


It begins with leadership.

The culture starts with leadership. So, if there's a culture problem in the business, nine times out of ten, it's because there's a leadership problem. Part of leadership is facing the truth.

The first step is to commit to creating a great culture that attracts and retains employees and at the same time provides a remarkable experience for patients. Once a great culture is established, it needs to be continuously reinforced through communication (written and verbal), feedback systems, observation by management, and problem resolution. Then the culture becomes easily replicated as you add locations.


Cultural clarity helps grow the business.

The clearer that you can get on what your culture is… what you want it to be… the clearer you can get on who fits that culture and what the behavioral norms are. You’ll improve hiring and retention. You’ll standardize your systems, so your employees know this is how we behave… this is what we represent… this is what we care most about... this is what we expect of you… this is what our patients expect of us… This standardized platform can then be profitably scaled.

To get there, you need to clearly outline and communicate your culture. As the dental owner or manager, you need to beat the drum every day, every week, every month, every quarter, every year. This is who we are. This is how we behave.

When employees don’t align with this and you’ve given them adequate opportunity to do so, let them move on to their greener pastures. They aren’t a good fit for achieving your goals.


Look at your calendar and your company checkbook.

If I want to know your priorities, look at your calendar and your checkbook. Those two things will tell you what you value. Steve Bilt has spoken about this concept, and I agree with him. If your calendar does not contain time scheduled for culture building or team brainstorming, then you aren’t valuing the impact of culture on your business.


Culture matters for:

  • Employee hiring, performance, and retention.
  • Patient engagement, experience, case acceptance, and loyalty.
  • Building a profitable, scalable foundation.

Dental group owners are ultimately accountable for this. You want to build the foundation of your business on people who fit your culture and are motivated to help you achieve your goals. So, clarity and commitment come first, then intentional effort and time dedicated to communicating the culture and resolving shortcomings in the culture’s defined preferred behavior. The effort you put into creating a great culture is going to result in a happier, higher performing team; better patient experience; higher revenue across all locations; and replicable, predictable behavior that enables you to scale.

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The Patient Prism blog and the Patient Prism Academy video library feature hundreds of dental industry experts presenting recommendations and examples for leading and growing your dental practice, multi-practice group, or DSO. We have many videos providing advice for entrepreneurial dentists. We invite you to schedule a Patient Prism demo at a date and time that is convenient for you. 

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