Merging Medical Practices: How to Create a Unified Culture with Better Communication

Healthcare in the United States is constantly changing and the way physicians practice today is dramatically different from 20 years ago. In order to maintain a successful private medical practice, one option is to combine practices to form one large group so you can gain economies of scale across operational functions such as billing, staffing, and IT, and leverage the collective bargaining power of the group when negotiating services such as health insurance, malpractice insurance, and benefit plan administration.

While merging groups and sharing resources can be helpful to control costs and drive profitability, integrating those groups beyond the bottom line is crucial to long-term success. Amalgamating into a larger organization with its own unique culture helps individual doctors and their staff feel like they’re working toward something bigger than themselves.

Capital Digestive Care was founded in 2009 when several smaller medical practices—specializing in gastroenterology—joined forces to become the largest GI practice in the Mid-Atlantic states. At the time, it was less common, but it was the beginning of an industry trend that has held strong for several years. 

In 2010, Capital Digestive Care expanded its infrastructure to include other core departments like marketing and information technology. At the time I joined the team, it was still a pretty blank slate. We had a name and a limited team of professionals all focused on leveraging the expertise of the more than 50 physicians who had been serving their communities for as many as 40 years. What we lacked at the time was the brand presence necessary to give voice to those experts. 

Within five years, we had established a marketing strategy, launched the brand, and checked all the boxes from a traditional marketing perspective, including a sophisticated website optimized for today's internet-dependent society. 

Delivering on a Brand Promise Through Daily Operations

To deliver on our brand promise, we rely on every individual who interacts with our customers to provide an experience that represents our culture and core values. Expertise and compassionate care are at the forefront of our brand, but it wasn’t enough to just put marketing components around these ideas. We had to consistently deliver on that through our service, staff, and physicians. 

Although our groups merged, they continued to operate somewhat independently. They still had the mindset of "We do things this way in our office."  The result was poor communication and collaboration and lack of connection between team members—some of the very challenges we wanted to solve by coming together in the first place. It quickly became pretty clear that we needed to develop a cohesive culture with its own core values and common language to address this issue.  

It was a big task because we have 300 employees spread across 19 office locations, including our administrative offices and specialized pathology laboratory. We didn’t have a tool that enabled conversations. We were solely an email-based organization, which is highly inefficient. Email, to me, is not a way to have a conversation. It also makes it difficult to keep track of the various initiatives from each siloed department where a lot of knowledge lives on individual drives. We needed a digital space where people could access information and engage in conversation and collaboration on various topics.

We also wanted to promote a sense of community among our own employees, the vast majority of whom don't know their colleagues. Their engagement and well-being impacts how they deliver service to our patients, so finding a platform that could help us address that was an important consideration.

Seeking a Unified, Efficient Digital Workplace

My impression of an "intranet" was an HR-managed site where employees go to download forms, so I distanced myself from the idea at first. I didn’t think it could handle our complex needs. As I learned more about the industry and the shift from a traditional intranet to a dynamic digital workspace, I realized it was exactly what we were looking for. 

At first, we considered building a custom internal solution because we had several tools at our disposal through Office 365. But I felt like that was never going to work. Trying to keep up with a custom solution is a full-time job. From a resource perspective, it just wasn't practical.

With that option off the table, I decided to work with an agency to help evaluate different products. We went through an exhaustive solution search process. That team introduced us to three potential solutions, one of which was Igloo’s digital workplace platform. 

The full process—from research and consulting internal stakeholders, to narrowing down our options and making a final decision—took about four months. During that time, the choice became clear: Igloo differentiated itself from the other contenders because of its product offerings and level of sophistication.

The Modern Tools We Need and the Supportive Service We Want 

Igloo has been incredibly supportive and helpful as we implement the platform. Igloo not only set itself apart thanks to the support team and their expertise, but they showed us a new way to connect and unify our offices. 

Their platform has that contemporary feel to it—a social media quality where you can have conversations and see other people's interactions—so it felt very current. When you work with a lot of staff who are in their 20s to early 30s, offering a tool that speaks to their generation is important because we want them to adopt it and to feel like we are on the cutting edge of industry best practices. 

As a private medical practice, we need to make sure we're on the forefront in all that we do. Regardless of whether it's how we care for our patients or how we operate and communicate as an organization, we need to lead—not follow. So that contemporary quality was an important selling point for me. And then the other piece was it had the capability to integrate with our various systems such as Office 365, allowing us to make the most of the tools we already have available to us. 

How to Optimize Your Digital Workplace Implementation Process

While we have only launched our site to a limited audience at the current time, it took off immediately with a high-level of adoption across our leadership. People just keep saying how much they love it, mostly I think because they are unburdened from having to keep up with their email and the fear of missing or forgetting something. It's been a journey and we’ve learned a great deal in the process. Here are a few key takeaways from our implementation:

1. Set a Clear Vision

Before you start, you need to have a good grasp of what you're trying to accomplish. The more you know about what you want to achieve from the beginning, the more successful you will be in the implementation. The hardest part for us was setting up all of the templates and interactions that will happen within the program. Without that clear initial vision, you will struggle to understand how different features can be utilized to achieve different goals, such as access to information and enabling collaboration.

2. Engage More Internal Team Members

Form an internal team to assist with the implementation and on-going support. While I did our transition myself, I realized in the middle of the process that it was just too ambitious for one person (who typically is performing other job duties). It doesn’t matter how busy everyone in your organization may be, you need adequate and ongoing internal support.

We have 300 people who will have never used this tool when we launch our workspace—it will be completely new to them. They're going to want to use the platform and they'll need to learn the basics, such as how to create a calendar or how to attach a document when posting something to their blog. The earlier we can teach this, the more success we will have in driving adoption of the program. 

3. Assign an Application Specialist

I didn't have the forethought in the very beginning phases to assign an application specialist to the project. Despite the fact that I’m leading the implementation, I can't be that person—I just don't have the time. I can be the strategic thinker and contribute to what we want this community to look like and what kind of interactions we want to have. But once it's live, I can’t give it the same level of support. I pulled an application specialist in during our final phases to help troubleshoot and train individual users on the ins and outs of different features. It's a critical role that we would have benefited from having on day one.

4. Connect to a Bigger “Why” for When You Go Live

You’ll want to go live with a platform that gets people engaged and excited—a site that is going to add value to their day-to-day work. If it doesn't, then people aren’t going to adopt that technology. I'm still finalizing those pieces, but our launch is in conjunction with a huge, two-year internal initiative. It's a cultural transformation we call Monumental Service.

Our teams across our organization are learning what it means to be part of Capital Digestive Care, our values, and how we want to deliver Monumental Service to all of our internal and external customers. We’re calling our Igloo site Capital Hill. For us, Capital Hill is part of our new culture transformation and identity. I'm putting the finishing touches on how Monumental Service is integrated with Capital Hill, so people now get to have another tool they can use to communicate with one another via this site. The goal is to empower them with the information they need in an accessible and engaging format.

5. Anticipate Adjustments and Process Change

In the planning process, it’s important to anticipate onboarding new users into your site. Will it be a manual process or is it going to be an integrated process? Either way, it needs to be consistent. Ensure you establish consistent protocols on how to collect user information and populate it into your system in advance. 

Our users can log in to Capital Hill with the same username and password they use for our organizational applications. Addressing these small—but important—protocols in advance will save you from having to retrain your team on best practices. 

Our implementation is likely very different from the typical process because it’s so connected to our culture transformation that's in progress. But I believe our lessons learned have universal applications.

Moving the Needle on Culture Transformation

Igloo is a critical component in moving the needle on our culture transformation initiative. It will help drive conversations, develop our cohesive community across our 19 offices, empower our people to give incredible service, and show them that we’re now all in this together. 

Every time we talk about it as a management team, the most common reaction I get is that people just can't wait for it to launch. Even though it's not fully launched yet, they're so relieved that we have a tool that will reduce their workloads and make it an engaging experience. 

Capital Hill will make everyone more self-sufficient. Our users are going to be so thankful they can get information on their own rather than having to jump through hoops. It’s the missing piece for us, and I'm very excited about it.

There are a lot of people with countless ideas across our 19 offices who often don't have a platform to share their thoughts and brainstorm with colleagues in different offices. Soon, we’ll have the platform to do that effectively. I would love for us to feel like we have more meaningful connections with each other and, for the first time, build a community as Capital Digestive Care.