Making an effort to learn the culture can go a long way.

As a third-generation eye doctor who joined a ready-made practice, my primary goal from day one centered around how I could help grow the practice. But, before I could do so, I needed to focus on two components of my transition into an already successful practice: becoming part of the practice culture and carving out a space for my clinical and surgical expertise. This required a delicate balancing act to showcase my knowledge and expertise but to avoid doing so in a way that would overwhelm the current makeup of the practice.

DON’T DISRUPT THE CULTURE

How you fit into a practice’s culture is a crucial aspect of whether you will succeed in that practice. If you cannot develop a favorable relationship with the existing staff, it doesn’t matter how smart you are or how many cataract surgeries you can perform in an hour. It just won’t work.

In many cases, you are joining a practice that performed just fine before you walked in the door. So, avoid coming in with the mindset that everything needs to be done your way and changes must be made immediately. Take it slow and learn the culture.

For example, when I first joined Williamson Eye Center, there were several instances in which I was asked how I wanted things done, such as cataract workups. Rather than try to do things my way, I asked how it was done before I arrived and tried that for the first few months.

Even though certain processes were not what I would have done, I was conscious to avoid being perceived as a young, arrogant surgeon who wanted to immediately change everything. After about 6 months, staff became more comfortable with me, and I was able to start suggesting changes.

DEVELOP A COMFORTABLE ATMOSPHERE

Another thing I learned was to make my personality and mindset for the day about everyone else. In the beginning, I was nervous in the OR and focused too much on the surgery itself and not on the staff around me. I played music that calmed me down, showed no personality and focused primarily on getting through the cases as efficiently as possible without interacting much with the nurses and techs. Later, I learned that the staff disliked coming to work on my surgery days, which is never what you want to hear.

After that, I started to ask the staff what music they wanted to hear, bought lunch regularly for the team and even cracked a joke or two. This created a more positive energy that transformed surgery days and made them a livelier experience for everyone.

BRING A NEW SKILLSET

As a surgeon just out of training, you are likely more of an expert in newer technologies and techniques than a senior ophthalmologist who has been out of training for 20-30 years. So, it benefits you and the practice to bring in a new level of expertise.

When I first joined my practice, we were not using femtosecond lasers and we did not implant multifocal IOLs or perform minimally invasive glaucoma surgery (MIGS). Within a year, I started doing all of these, because I had the training to be able to offer these services.

Unlike the case with practice culture changes, you may be able to come in on day one and start making these changes. For example, MIGS doesn’t require much in terms of costs and will result in additional revenue for the practice. However, you don’t want to come in and immediately ask for a bunch of new, expensive toys. Start by presenting a pro forma that details the finances involved and why a new equipment purchase is worth the investment.

CONCLUSION

When you enter a practice as a new physician, all eyes are on you. By being conscious of not upsetting the culture while adding new revenue streams and services at a slow but steady pace, you will give yourself the best chance at a successful transition. And that success is critical to your efforts to help the practice grow. OM

Blake K. Williamson, MD, MPH, MS, is a refractive and anterior segment surgeon at Williamson Eye Center, Baton Rouge, La. Email him at blakewilliamson@weceye.com