Workplace Culture
Derailed!
How to Get Your Practice Back on Track
6 Genesee Valley Veterinary Medical Association
Veterinary professionals are dedicated to promoting optimal health in and for their patients. Most practitioners do not promote that same care for their hospital’s organizational health, either because they do not understand its’ impact or because they do not know where to start. When practices are left to manage themselves, daily chaos is the norm. Chaos can be recognized by a lack of teamwork and professionalism, inefficiencies and a lack of common guidelines that help to create consistency in how team members do their work. How can practice leadership keep their practices on track, creating a cohesive workplace culture where veterinary team members feel safe, heard, respected, and work collaboratively to achieve co-created outcomes?
Culture is defined as “the set of shared attitudes, values, goals and practices that characterizes an institution or organization.”1 All veterinary practices have a workplace culture, which may manifest in different ways:
Healthy Workplace Cultures
A healthy workplace culture is the single biggest factor in creating a successful veterinary hospital. A healthy culture is critical in creating an environment in which all employees can grow and thrive. Workplaces with healthy cultures report greater employee engagement, job satisfaction and more effective teamwork. Healthy workplace cultures have leadership that has adapted by expanding their skill sets to help empower employees. These leaders successfully manage themselves by understanding how their actions (or lack of actions) impact their followers.
Neglected Workplace Cultures
Culture is neglected when leaders fail to define, create, and reinforce shared values and goals. Neglected organizational culture is unmanaged; there are no guardrails and chaos ensue. Due to lack of leadership, each faction in the practice operates under its own guidelines. This leads to misunderstandings, confusion, and resentment among animal health care team members. The impact on teams is often higher rates of absenteeism, burnout, and turnover. Neglected cultures are at risk of devolving into toxic workplaces.
Toxic Workplace Cultures
A toxic culture is one in which employees dread going to work; it is common for them to feel anxious or stressed as they pull into the parking lot. Toxic culture was the single best indicator of turnover in the first 6 months of the great resignation2. Multiple studies have found that working in a toxic environment is associated with higher levels of workplace stress, burnout, physical illness, and mental health issues. Toxicity leads to turnover, with one study citing that “1 in 5 employees left a job at some point in their career due to a toxic culture”2. Less engaged employees are 20% less productive than those who are engaged in their job, due to decreased effort and absenteeism. Finally, in today’s connected world, toxic cultures are well known to job seekers; having a toxic employer brand makes it harder to attract candidates.
What creates a toxic culture? There are five factors that drive behaviors seen in toxic cultures2:
• Noninclusive
Exclusion occurs in hospitals when there is a perception that everyone is not treated fairly or uniformly welcomed, based on factors like “gender, race, sexual identity and orientation, disability and age”2. It is worsened when leaders hold employees to
different standards, playing favorites or when cliques are allowed to form, excluding others without specifying why.
• Disrespectful
Feeling disrespected has been identified as the factor that most negatively impacts an employee’s overall perception of their workplace culture. These feelings are strong when there is a lack of consideration, courtesy, and dignity for others. In surveys, respect toward employees rises to the top of the list of cultural elements that matter most 2
• Unethical
Unethical behavior impacts employees at both the organizational and personal level. Common terms used by employees to capture the emotions of working in an unethical environment include shady, cheat, unethical, mislead, and lying.
• Cutthroat
This emotion is present in the workplace when employees feel a lack of collaboration and teamwork at the organizational level. At a personal level team members felt undermined, describing their environments as ‘dog eat dog,’ being thrown under the bus and that teammates stab each other in the back 2
• Abusive
“Abusive management has been defined as sustained hostile behavior toward employees”2 by those in leadership positions. Leadership behaviors that are abusive include “bullying, yelling, or shouting at employees, belittling or demeaning subordinates, and talking down to people”2
How Leaders Facilitate Toxic Workplace Culture
The best predictor of toxic culture can be found by looking at leadership3. Reshaping practice culture requires that leaders be willing to hold themselves, and all employees, accountable for behaviors that lead to neglected and toxic workplaces.
There are three primary drivers of toxic behavior, which are toxic leadership, toxic social norms, and poor work design3:
Toxic Leadership
Leaders are rarely accountable for the actions of poorly behaved employees 4. Leadership actions, either directly or indirectly, may enable poor behavior that violates agreed-upon practice norms. These actions negatively impact individuals who are on the receiving end of coworkers’ abusive communication styles or the target of gossip. The practice can be harmed when an employee fails to adhere to practice policies, creating inconsistencies in how client management and patient care is delivered.
Social Norms
Social norms are behaviors that are desirable and acceptable in the workplace. Norms develop implicitly and if not actively managed they will dictate team dynamics. Examples of unchecked social norms include habits and unspoken ‘rules’ like who sits where and who has the most influence.
Work Design
In studies, poor work design has been found to contribute to stress and lead to toxic behaviors. Work design with the highest correlation to toxic cultures include workplaces with role conflict, excessive workloads, and role ambiguity.3
Genesee Valley Veterinary Medical Association 7
Getting Practice Culture Back on the Rails
Creating and maintaining a healthy workplace culture is the single most impactful job of practice leadership. It requires commitment and guidance that trickles downward from the practice owner to all employees. It is the responsibility of the owner, manager and all team leaders to model and reinforce the behaviors that are expected in the workplace. Where does a leader start?
Define What is Important Within the Practice
What are the organizational core values that define how your team does their work and treats others? Shared core values serve to define the mutual beliefs about the ‘identity’ of the practice, which is the role the practice plays every day and why it is meaningful to pets, clients, employees, the community, and the veterinary profession. Shared core values should serve to guide all actions leaders take every day.
Model Desirable Behaviors
Veterinary team members take their cues about acceptable workplace behaviors by watching what practice leaders do and how they act. This helps team members understand what behaviors are “encouraged, expected and tolerated.”3
Every leader within the practice has an obligation to reinforce the shared values through their actions. This includes desirable actions as well as regulating emotions that are better off suppressed. An example of this is when a veterinarian or team lead within the practice avoids labeling clients as ‘difficult,’ ‘cheap,’ ‘unreasonable,’ ‘emotional’ or other derogatory terms. When a leader voices these feelings, even behind closed doors, it signals to the team members that it is acceptable to negatively label clients. These attitudes adversely impact the client-practice bond, as well as serving as a source of toxic emotional culture for the entire team.
Don’t Ignore Toxic Behaviors
Toxic behaviors often exclude people from feeling like part of the team. In veterinary practices it is common for schisms to form based on different employment roles, such as front desk team and patient care teams: credentialed veterinary technicians/veterinary assistants. Rather than working together to uphold shared values, they form sub-teams based on ‘front of hospital’ and ‘back of hospital.’ Too often, each sub-team forgets that they are on the same team, working toward the same purpose. Hostile behaviors such as gossip, dismissive language (both verbal and non-verbal) and an unwillingness to help each other characterize toxic behavior. In these situations, it is critical that practice leadership steps in quickly to extinguish this behavior. Effective tools include clearly defining behavioral expectations and training teams in collaboration skills such as empathy, communication, self-awareness, and attentive listening skills.
Clearly Define Role Expectations
Leaders unknowingly contribute to workplace toxicity by failing to delineate roles within the practice. A glaring example of this is the lack of differentiation between credentialed veterinary technicians and veterinary assistants. The 2022 NAVTA Demographic Study5 found that two main barriers to full veterinary technician utilization included
“Lack of title protection within the practice” and “Lack of a clearly defined scope of practice for credentialed veterinary technicians with a practice”. There are four ways this should be addressed in practices:
• The title “veterinary technician” should be reserved for team members who are graduates of a program accredited by the AVMA. Other animal care team members should be titled “veterinary assistants.”
• Define what tasks are to be performed only by veterinary technicians versus what can be delegated to veterinary assistants. State practice acts are a useful resource to help differentiate the activities performed by the distinct roles.
• Tailor work within each role to what motivates each employee. Rather than expecting your employees to perform all tasks listed in the job description, match expectations with the strengths and interests of each team member.
• Create pathways to growth within each position in the hospital. In most veterinary practices, there is no opportunity for advancement within a position. This stagnation is a driver for workforce attrition. Design levels within each position, with specific goals to be met before team members can advance to the next tier. Clearly outline increases in pay and benefits associated with each of these new stages. Outcomes of this process include increased employee engagement, development, and autonomy; the individual can decide if they want to advance or are satisfied with their current role.
Cohesiveness is the act or state of sticking together tightly, in unity and togetherness. It is the outcome of creating a healthy workplace culture, where trust is cultivated, and employees are fully engaged in work that is meaningful to them. Clients recognize this positivity and feel validated about their choice of pet health care providers, which leads to more stable, successful businesses. When hospital leaders commit to keeping practices on track by creating and maintaining cohesive, healthy workplace cultures it is a win-win for everyone.
References
1. https://www.merriam-webster.com/dictionary/culture Accessed 12/14/2023.
2. Sull D, Sull C, Cipolli W, Brighenti C. Why Every Leader Needs to Worry About Toxic Culture. MITSloan Management Review, March 16, 2022.
3. Sull D, Sull C. How to Fix a Toxic Culture. MITSloan Management Review, September 28, 2022.
4. McAllister CP, Mackey JD, Ellen III BP, Alexander KC. Bad Apples or Bad Leaders? MITSloan Management Review, January 3, 2023.
5. NAVTA 2022 Demographic Survey: bit.ly/3Fsi4gf
Wendy Hauser, DVM Peak Veterinary Consulting
Wendy Hauser, DVM is the founder of Peak Veterinary Consulting and has practiced for 35+ years as an associate, practice owner and relief veterinarian. She has worked in the animal health industry as a pet health insurance executive and as a technical services veterinarian. She is a member of the AVMA Veterinary Economics Strategy Committee. Dr. Hauser, passionate about education and innovation, consults with both industry partners (established and start-up) and individual veterinary hospitals. She is a regular presenter at veterinary conferences, facilitating workshops on hospital culture, communication, leadership, client relations and operations. Frequently published, she is the co-author of “The Veterinarian’s Guide to Healthy Pet Plans.” Learn more about Peak Veterinary Consulting at https://peakveterinaryconsulting.com/.
8 Genesee Valley Veterinary Medical Association
