AE July/August 2018 Vol 27 No 4 - 29

At Texas Retina, Bill Koch makes "sure that new
staff fits into the culture that's developed over the
years." Asked how he hires to the culture, Koch
explained, "Rather than regimented questions, I just
have a conversation with the interviewee." Koch
recalled speaking with a candidate who talked about
working in a self-centered rather than a team-oriented way. He added, "I can tell almost immediately if
the person will fit in."
Stacey Koch described another benefit, saying "The
only way to be confident about what's going on behind
closed doors in a bigger practice is by making sure that
all those hired fit our culture coming in."
In contrast, Advanced Eye Care, SC, found it too
difficult to maintain its culture of flexibility after expanding. Sykora explained, "In the past, if employees had family commitments or required modified
working arrangements, we could always accommodate them while meeting practice needs. Now that
we're bigger, we are discovering a need to be 'by the
book' because the staff is more competitive in terms
of perceived fairness." She noted that this means
"rewriting the handbook and living by it so everyone
is on the same page."
Nevertheless, Utah Eye Center administrator Jimmy
Smith recommends two important steps for practices
that want to head off or smooth over the challenges of
culture management:
* Communicate clear expectations
* Develop good relations among staff at all levels

"Improper expectations
and poor communication
will have as much of an
effect on the outcome of an
acquisition or expansion
as a lack of patients or
inadequate resources."
-Jimmy Smith,
Utah Eye Centers

"Now that we're bigger, we
are discovering a need to
be 'by the book' because the
staff is more competitive
in terms of perceived
fairness."
-Christine Sykora, JD,
Advanced Eye Car, SC
"Everyone will have different expectations," Smith
emphasized. "Employees can be territorial and view
growth as an opportunity to gain greater influence.
Physicians can be unrealistic. They may have a comfortable working relationship with a few technicians
and resist working with a larger pool. Improper expectations and poor communication will have as much of
an effect on the outcome of an acquisition or expansion
as a lack of patients or inadequate resources."
In fact, Evergreen Eye Center (Puget Sound region,
Washington), a practice with 105 employees that is
currently merging with a much smaller practice, is
also concentrating on developing employee relations.
According to its former practice administrator Zachary
(Zach) Smith, MHSA, COE, "We've made a focused
effort to build relationships between key staff members
in our practice and their counterparts in the merging
practice... . One-on-one interpersonal relationships
will be the key to transmitting our culture to the merging practice without the employees there feeling as if
they are part of a hostile takeover."
SATELLITE OFFICES
Practices that expand geographically also face the risk
of becoming siloed with different policies and procedures in different offices. As Bill Koch explained, "Our
main office is in Dallas. The distant offices struggle
with processes and maintaining the culture."
Additionally, having distant offices may complicate hiring. Zach Smith pointed out that Evergreen
Eye Center has a clinic and an ASC in one building
and two other clinics nearby, and it is merging with a

www.asoa.org // AE

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http://www.asoa.org

Table of Contents for the Digital Edition of AE July/August 2018 Vol 27 No 4

AE July/August 2018 Vol 27 No 4 - Cover1
AE July/August 2018 Vol 27 No 4 - Cover2
AE July/August 2018 Vol 27 No 4 - 1
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AE July/August 2018 Vol 27 No 4 - 27
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AE July/August 2018 Vol 27 No 4 - Cover3
AE July/August 2018 Vol 27 No 4 - Cover4
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