Influencing Office Culture and Success

New graduates can bring unique strengths—fresh clinical knowledge, adaptability, and a willingness to embrace new technologies—that can benefit patient care and the overall success of a practice. I was able to accomplish this by taking the following steps:

1. I LEARNED ABOUT THE CLINIC ENVIRONMENT

Every practice has its own history, workflow, chain of command, and interpersonal dynamics. I took time to learn these things. First, I considered communication styles: How did doctors and staff interact? Second, I evaluated the decision-making process: Who set the practice policies, and how were new ideas introduced? Third, I assessed the practice’s amenability to change: Did it adapt quickly? By listening and observing, I was able to identify where my voice may add value without disrupting the existing foundation of the practice. One example: I recognized an opportunity to expand the management of dry eye disease (DED) within my practice. In a rural hospital-based setting, I noticed that many patients were experiencing significant ocular surface disease symptoms but did not always have access to comprehensive DED evaluation and treatment. Because of my residency training and interest in ocular surface disease, I felt I could bring additional expertise to this area. I discussed the opportunity with the physicians and staff and was able to add value, while complementing the services already being provided.

2. I BUILT CREDIBILITY THROUGH CLINICAL EXCELLENCE

I discovered that the fastest way to gain respect and, therefore, a seat at the decision-making table was by demonstrating both my clinical competence and reliability. I accomplished this by showing the practice’s decision-makers that I was staying up to date on evidence-based care, being proactive about comanaging complex cases, maintaining thorough documentation and communication, and balancing confidence with humility. I was able to contribute to the care of patients who have complex ocular surface disease, glaucoma, and perioperative disease. Working in an OD-MD setting, these cases reinforced the importance of clear communication and understanding each provider’s role. Demonstrating that I could independently manage cases, while also recognizing when collaboration or referral to my ophthalmology colleagues was warranted helped me establish clinical credibility and trust within the practice.

3. I BUILT STAFF RELATIONSHIPS

From day 1, I showed appreciation for staff roles, from technicians to the front desk. I found that doing so fostered an environment where every staff member felt valued and included, which strengthened the practice’s culture of teamwork.

Specifically, I made it a priority to check in with my fellow staff members before the clinic day started to ask whether I could provide any assistance. Additionally, I invited technicians into discussions about patient protocols.

I found that a new OD who takes the time to learn staff members’ names, understand their workflows, and acknowledge their contributions quickly earns trust and respect.

4. I ADDED A SPECIALTY

I launched a DED clinic, offering a service that improved both patient care and practice growth. Adding a specialty does not necessarily mean creating a new department within a practice. Young ODs can identify opportunities based on both their interests and the needs of their patient population. Depending on the practice setting, this could include myopia management, specialty contact lenses, glaucoma, pediatrics, low vision, neuro-optometric care, or ocular surface disease. The goal is not simply to add another service, but to develop an area of expertise that fills a need within the practice and community.

MAKING AN EARLY DIFFERENCE

Influencing office culture and success as a new OD does not require a leadership title. Instead, I discovered it requires understanding the clinic environment, building credibility through clinical excellence, establishing strong relationships with staff, and introducing thoughtful innovations, such as an optometric specialty. These steps helped set the stage for long-term professional fulfillment.

If I could go back to my first year of practice, I would spend even more time listening before trying to implement change. As a new graduate, it is easy to be excited about new ideas and want to immediately put everything you learned during residency into practice. However, the people who have been working in a clinic for years often have valuable insights into why certain workflows exist. I have learned that asking staff and colleagues what is working, what is not working, and what they would change can provide a much better starting point than coming in with a predetermined solution. I have found that the most effective change comes from collaboration.