Creating a High-Performance Culture

By April Jasper, OD

When we talk about leadership in optometric practices, one of the most important yet overlooked components is the intentional development of a high-performance culture. It’s not something that happens by accident, and it’s not something that can be outsourced or delegated. Culture is created and sustained by all of us—from practice owners to team members—and its impact on performance and profitability is profound.

Leadership Starts With Us

In previous discussions, we’ve emphasized that leadership is an inside job. It starts with self-awareness, and it continues through every action we take and every example we set. When things go wrong in my practice, the first place I look is in the mirror. This isn’t about blame—it’s about ownership. We can’t expect our teams to embody excellence if we don’t demonstrate it ourselves.

What Is Culture, Really?

Culture is more than mission statements and motivational posters. It’s the lived, felt experience within your practice. It’s a set of shared beliefs, values, and behaviors that determine how your team interacts, how they serve patients, and how they solve problems together.

Think of it like the weather—you can feel it the moment you walk into the room. Whether written or not, your practice has a culture. The question is: is it serving you and your patients? Or are you tolerating behaviors that detract from performance?

Culture Is a Strategic Advantage

Peter Drucker once said, “Culture eats strategy for breakfast.” You can have the best business plan on the planet, but without an engaged, values-aligned team, it won’t matter. Culture is the only sustainable competitive advantage that is fully within your control as a practice owner.

And the data backs this up: high-performance cultures lead to a minimum of 21% greater productivity and 22% more profitability. These aren’t small gains—they’re transformative.

Values Need to Be Operationalized

One of the biggest mistakes I see in practices is treating core values as decorations rather than directions. Less than 10% of businesses actually operationalize their values—meaning they don’t take the time to define what each value looks like in daily behavior.

For example, one of my personal core values is integrity. For us, that means always putting the patient first, even when it’s inconvenient or costly. It means owning our mistakes, being transparent, and doing the right thing without hesitation. If we accidentally overcharge a patient, we fix it immediately. If something doesn’t feel right—even if we technically didn’t do anything wrong—we take the time to explain and reassure.

Your team needs to understand what living your values looks like in action. Break them down into concrete, observable behaviors. This clarity creates accountability and alignment.

Co-Create the Culture With Your Team

Culture shouldn’t be a top-down mandate. When you involve your team in defining what your values look like in practice, you create buy-in. They feel ownership over the culture because they helped build it.

A simple exercise is to take your top five values and ask your team to help define two or three concrete behaviors that demonstrate each one. This collaborative effort helps move abstract ideas into daily actions and creates a culture code you can use in hiring, training, and coaching.

Coaching as a Leadership Style

The style of leadership you adopt directly impacts culture. A coaching leadership style—one focused on observation, feedback, and support—is essential in sustaining high performance. People develop best in response to other people. They thrive when they’re seen, heard, and valued.

This doesn’t require long-winded performance reviews. A weekly five-minute check-in with each team member—asking about their priorities, obstacles, and how you can support them—can make all the difference. Consistency is key. Cadence matters.

The Cost of Avoidance

Too often, we avoid difficult conversations. We let underperformance slide to keep the peace and overload our top performers because we trust them. But this creates a culture of mediocrity. High-performance cultures thrive on clarity, fairness, and continuous feedback—not avoidance.

Culture as a Patient Experience

Your patients feel your culture. It shows up in how your team interacts with them and with each other. I've learned the hard way that the tone we set internally shapes the patients we attract. If we tolerate dysfunction, disorganization, or negativity, it becomes part of the patient experience.

We’ve all been to offices with beautiful buildings but terrible energy—where the décor was inviting, but the team dynamics were toxic. That disconnect can’t sustain premium pricing or long-term loyalty.

The opposite is also true: when your team culture is strong, patients want to be part of it. They trust you more. They return more often. They refer others.

Build It and Protect It

Culture isn’t static. Every new hire changes the dynamic. That’s why it’s essential to integrate your values and behaviors into the hiring and onboarding process. You’re not just hiring for skills—you’re hiring for culture fit.

Your team’s engagement and your patients’ experience all tie back to one question: what kind of environment have you intentionally created?