Maintaining Culture as Your Business Grows

By the time they come to us, our healthcare clients have already established that growth is a priority. As we’re putting together a roadmap for what that growth will look like, there’s usually another priority in our clients’ minds: culture. Specifically, how to keep a positive culture in place as the business grows.

We know that practice owners pour a lot of effort into building a positive culture at their first location. And with these tips, you’ll be able to maintain that culture among employees and patients at every new location. Here are a few ideas to get you started.

Scaling a medical aesthetics practice? Read our tips on what to consider as you grow here

Scaling a DSO? Here are our top DSO scaling strategies for 2023. 

What Does Culture Look Like in a Healthcare Practice?

First, let’s bust the myth that culture is about having great benefits or Friday afternoon pizza parties. While these might be indicators of a good culture, what matters more is how it feels to work at your practice. When employees feel supported, invested in, and excited to be at work, these are green flags for the state of your company culture. Inversely, a toxic workplace culture often leads to the opposite: employees who don’t feel supported, valued, or happy at work. 

When it comes to growth, practices with positive cultures are better positioned for expansion. There are many intangible benefits to a positive culture like lower employee turnover, higher production, and even more loyal customers.

Of course, this doesn’t come automatically. Most of the time, small businesses with strong cultures have intentional mission statements and core values that they’ve built into every aspect of the practice. They have passionate leaders who keep the missions and values at the heart of hiring decisions, branding, and even operations. And, they have processes that prevent some conflict and frustration that leads to a toxic environment.

Let’s see what that looks like at the practice level.

How Do Practice Owners Foster a Positive Workplace Culture?

Before we get ahead of ourselves and talk about growth, let’s start at building a strong foundation. Here are some ways to create a positive workplace culture that makes your staff excited to walk through the door each day.

Values, Mission, and Vision

Words can’t define the organization’s culture. However, they can act as solid reminders of who you are, what you care about, and how you want to treat people who interact with your business. That’s why it’s important for leaders to come up with a clear mission statement, vision, and core values.

(If you already have a mission or vision statement, consider whether it’s an accurate reflection of the business. It might be time to restructure that statement to reflect who you are.)

Once your company values are identified, remember that to build them into the culture, they need to be practiced and experienced by every employee and patient. That is why communication is key. You can list your mission statement or values on your website, business cards, advertisements, and on the walls of your practice.


Communicating a positive culture isn’t just about telling your employees your core values or posting your mission on your website. (Though, it’s a start!) It’s also about creating an environment where people feel safe to give and receive feedback. It’s important for leaders to create lines of communication between all providers, staff, and patients–they will be the true mirrors of workplace culture. What do employees care about? What are their goals? How might they be struggling? Do they have great ideas to share? How do they best feel supported? Not only is communication key to understanding your culture, it will be key to expanding it as your organization grows.

Processes for Hiring, Training, and Developing Your Team

People are the heart of your practice’s culture. That’s why it’s so important to hire and train a team equipped to carry out the values and mission of your business. So, make sure that throughout the training process–from hiring to training to goal setting–your company’s vision is clear. You’re more likely to find team members who are a culture fit if you can clearly identify and describe some key elements to the culture. 

When hiring, look for creativity, problem-solving capabilities, and, above all, a positive attitude. If you’re heading for growth, these are the types of people who can help take you to the next level.

Here are more tips for building culture into your team development:

  • Collaborate with all staff (providers, front desk, hygienists, etc…) to set personal goals. Whether this is through quarterly reviews or regular conversations, it’s important for leaders to know what team members value and are working toward.
  • Ask questions! How are team members motivated? How do they like to communicate? What are they passionate about? This starts at the interview, but it should continue throughout each person’s employment.
  • Create a safe environment for informal check-ins. Feedback shouldn’t only be given in formal settings–and that goes both ways. Leaders, managers, and team members should be able to share ideas in productive ways and feel included in carrying out the company’s vision.

Finally, remember that the best hire is the one you don’t have to make. In other words, keeping employee retention high and turnover low is key to a consistent culture. Promotions, pay raises, benefits, and respecting individual employees’ needs will get you a long way.


Underlying all of this is solid leadership. And for leaders to foster a positive culture, they need to spend time where the people are. Great leaders have a true pulse on every position in the practice–spending time at the front desk, with patients, and with providers.  An aloof owner who communicates from behind a computer screen won’t have much impact on company culture. But one who’s in the office and feels like part of the staff will.

If you’re just starting, answer a simple question: What does workplace culture mean to you? What do you want your practice to feel like–for employees, patients, and yourself? Once you’ve got that nailed down, it’s time to put it into action at an operational level. Of course, note that “culture” is not the same as “policies.” Policies might help set boundaries, but culture sets the tone.

How Can Leaders Maintain Workplace Culture as Your Business Grows?

If you’ve recognized the strength of your current culture, congratulations! You’ve already done the first part—you’ve got the secret sauce for a happy, productive team. Now, you can learn how to carry the culture as your business grows–from one location to many. 

Here are a few tips for maintaining culture as you open new locations:

  • Communication is key. Be clear about your shared vision, mission, and values, and create an environment where people feel empowered to share in it. 
  • Hire people with a growth-minded attitude. Make sure you have an interview process that helps you to figure out if people are ready to grow along with you.
  • Be willing to stay flexible and fly the plane while you’re still building it. Even if you’ve done it once, every new venture is different. Be willing to adapt and find new ways. Chances are, your culture will be stronger for it.
  • Be transparent about your growth goals and dreams. That way, everyone can feel included in the vision.
  • Train the trainer. If you’ve led a solo practice, you already understand the importance of delegation. Create more leaders ready to help your business thrive.

Keep in mind that how you grow will impact how you’re able to duplicate culture. A de novo strategy is a clean slate. You’ll get to hire your team from scratch with the same values, mission, and procedures that worked the first time. Acquisitions can sometimes pose more challenges, but with clear communication and collaboration, you can identify the shared values that will set the tone for a strong shared culture.

Skytale Group Can Help Your Business Grow Effectively

At Skytale, we’re in the business of growth—but growth that lasts. We don’t want your employees to burn out or your cash flow to run dry. Our combined decades of experience leading medical aesthetics and dental practices to success have taught us how to help businesses like yours grow in a sustainable way.

If you’re ready to partner with a financial CFO and growth guru, please get in touch today.