How to Build a Feedback-Rich Environment in Your Group Practice: Tips for Open Communication and Growth

Feedback isn’t a “nice-to-have” in a group practice - it’s a must. But most people cringe at the thought of it (giving it and receiving it). For a variety of reasons, of course. Either the feedback they’ve received in the past was poorly handled, or they’ve never had a safe space to speak up in the first place, or they’ve tried speaking up and were ignored, or they’ve been given feedback wayyyy too harshly.

So, as a practice owner, how do you build a practice where feedback flows like wine and your team isn’t scared to offer their two cents?

I promise you, this is doable.

Why Creating a Feedback-Rich Environment Matters

[You thinking, “it doesn’t” is fighting words. Don’t even think to come at me with that nonsense. Feedback absolutely matters!]

Okay, so long and short is that feedback keeps your practice thriving and your team happy. But here’s why it’s crucial:

• Boosts Trust
  It seems silly, but giving and receiving feedback allows for heightened levels of trust. They’re besties, folks. When your team knows their input is valued, they’ll have higher levels of trust in you, which leads to more conversations and, importantly, more open conversations. Also (added bonus): fewer awkward silences in meetings.

• Increases Engagement
  People want to feel heard. Any why shouldn’t they? People who feel heard are more engaged and motivated - they feel (and are) taken more seriously and thus more invested in the conversation at hand. Without feedback, your team members will probably start to check out. Nobody wants to talk to a brick wall or feel like they’re screaming into the bayss. The last thing you want (or need) is a bunch of resentful-at-not-being-heard employees who start to disengage from you, their peers, and the practice.

• Nips Problems in the Bud
  This is such an understatement. If we can incorporate consistent feedback into our processes, we can resolve or fix or sidestep small issues that, without that resolution/fix/sidestep, could have become significant problems. If your practice is rich in feedback, you’ll constantly have a finger on the pulse of what’s happening that’s problematic, even in the small sense, and thus can make any necessary tweaks for smoother sailing. All because somebody was brave enough to give feedback.

The Biggest Barriers to Open Communication in Group Practices

It’s important we talk about this. I would contend that a lot of the barriers to open communication can come from the top and then trickle down to the hiring process. If you’re reading this, then you’re a person who probably does want feedback. And if that’s the case, even though we all say we want feedback, there are a generally a few big reasons why it doesn’t happen.

• Fear of Judgment
  Employees often worry that giving feedback will make them look bad or cause tension. They fear retaliation or awkwardness, so they stay silent. This is made worse when employees come from places where that sort of negative response to feedback did occur. This can either be a pour-over from past employment or a lack of assuredness about the current environment (and probably more, but those are two big ones).

• Power Dynamics
  As much as group practice owners might not like to admin this, there is a hierarchy in a business. The owner is at the top. This is non-negotiable, even if it’s uncomfortable to accept. And with that hierarchy, there comes power (and responsibility). Employees can start to question, “why would the boss listen to me, anyway?” Or, worse, “I don’t want to get in trouble for speaking up about something.” This is terrible because then we end up not getting the feedback we need, leading to gaps in knowledge (and a lack of ability to rectify issues).

• Lack of Psychological Safety
  This is such a big one. Employees must have a sense of psychological and emotional safety to speak up. This isn’t something you can force on your employees. It takes time and experience (like, a lived experience of it happening) for people to believe it. If your employees don’t feel emotionally safe to speak up, you can ask for feedback all day, but you won’t get it. People will not be vulnerable if they don’t feel safe, and the more safety you can help to create, the bigger risks employees are willing to take.

• Stale Questions
  Omg, seriously. If one more group practice owner asks, “How are things going?” to their employees, I’m going to pull each strand of my hair out. Ughhh, nobody wants to answer boring-ass, stale questions! And the types of lame questions being asked result in lame answers being given. “How are things going?” = “Good!” [<- Is that really the type of feedback you want?]

Omg, I can hear you in my head right now. “Yeah, but I’ve tried to get feedback at my practice and nobody gives it. People don’t want to give feedback. I don’t know how to get it.” Goodness, I hear you. I disagree with you about some of those strong statements, but I can at least hear your frustration about feeling like you’ve done your part and come up empty.

What’s the fix, you ask? Love it.

How to Encourage Open Communication in Your Practice

Here are some tried-and-true strategies to get that feedback flowing - and no, it doesn’t involve bribing your team with donuts (although that wouldn’t hurt).

1) Use Metrics and Structured Feedback Regularly

Let’s start with the basics. Ongoing feedback needs structure, and performance-based metrics are your best friends. This shouldn’t be a once-a-year event, either. Here’s what we do:

• Performance Metrics
  Available 24/7 to give everyone a clear sense of where they stand. People should always know how they’re doing. This allows for regular direct feedback about the work being done, as well as the ability for a higher up to check in when they see things are off. This is way more “low stakes” than waiting for an “annual performance review” (which I really don’t love).

• Quarterly Conversations
  If you don’t know about my love for EOS, I’m getting this from EOS. These are half-hour, optional* check-ins where you can open up to your whole team to schedule. The two questions (and only two) that you ask are, “what’s working?” And, “what’s not?” This is giving employees a low-pressure way to air their thoughts.
  *We make these optional, but I’m pretty sure EOS indicates they should be mandatory.

• Bi-Annual Reviews
  These are not performance reviews (see performance metrics two bullet points up)!! Twice a year, meet with employees to dive into values, vision, and overall culture. You can review metrics, but not in a punitive or singularly focused way - this review is less about performance and more about fit, satisfaction, and the bigger picture, including what each employee wants out of their role and tenure with your practice.

• Monthly Team Check-ins
  This is a simple one and doesn’t necessarily result in a lot of feedback, but it send a bigger message that feedback is wanted. I send a monthly check-in email to the whole team with a variety of information, including a call to action for sharing any feedback they may have regarding the culture, systems they’re a part of, hiccups they’ve noticed, or ways to improve the practice.

2) Create a Culture of Psychological Safety

You can have all the feedback tools in the world, but if your employees don’t feel safe using them, they won’t.

I’ve consulted with many group practice owners who don’t understand why they’re not getting feedback, but then regale a story of responding defensively when given feedback. That sort of response is going to erode psychological or emotional safety almost immediately, and it sends an implicit message to others that feedback isn’t welcome.

If you’re wanting to ensure that feedback be real and genuine and consistent, there are a few key things that need to take place.

• Hug the Messenger
  Not literally (unless it’s consensual). When someone brings you feedback, thank them. It is so important that you appreciate the fact that they spoke up to you, even if it was something hard to hear. In doing so, you’re making it known that feedback is not only accepted, but celebrated, which will generate a cycle of continuing to receive it.

• Solicit Feedback Regularly
  I mean, I think this one goes without saying, but you should be soliciting feedback on the regular. Don’t wait for your annual (or bi-annual or quarterly) review. Ask for feedback in real-time - at team meetings, during monthly check-in emails, after interviews, and any other place where you can fit it in appropriately.

• Own Your Mistakes
  This one might be a little odd to read, but bear with me. If you can publicly (at your practice) own your mistakes, what you’re doing is letting your team know that it’s okay to mess up, it’s okay to be honest and candid, and it’s okay to be human. This helps to cultivate a sense of vulnerability, which breeds more psychological and emotional safety, which results in more and better feedback when requested.

3) Ask the Right Questions

Your questions are everything. You already know I don’t like stale-ass questions. Here are a few examples of ways to change what you’re asking so that you can be more specific and, ideally, get better responses.

• “What’s one thing you’d like me to start doing that I’m not doing now?”

• “How can I help you be more effective in your role?”

• “What’s one thing I can do better as a leader?”

• “What is one thing you would change at this practice to make it better for employees/clients?”

• “What is one thing you wish was different at the practice/about your role?”

Asking these kinds of questions shows that you genuinely care about what your team has to say.

Feedback Doesn’t Mean You Have to Change Everything

Here’s the caveat to all of this. You still own the practice. You are still the boss. You still get to make the decisions.

I would contend that good feedback should be responded to and implemented immediately, if possible. However, not all feedback results in a change being made at the practice. Sometimes, getting feedback allows for an opportunity to clarify why ‘something’ is in place the way it is, which still has a positive impact on the person who has given the feedback.

I think that some practice owners get nervous about feedback, in that they think if they receive it, they have to be at the mercy of the giver. But you don’t. You just need to listen to the feedback, attempt to integrate it with your current vision, value system, and infrastructure of the practice, and then respond. A response can vary from, “wow, that’s actually an incredible idea and I’ll add that to our annual vision meeting agenda,” to, “I really appreciate you sharing this with me. I don’t have an answer right now for you, but let me reflect and I can let you know if anything will change in 'xyz’ regard,” to, “Wow, thank you for sharing with me. I hear ‘the feelings’ and, if I’m understanding correctly, your feedback is that ‘paraphrase feedback.’ I respect where you’re coming from and I have additional information about why we can’t do ‘xyz’ right now or maybe ever, if you’re open to hearing?”

The essence of all of this is that feedback is important data to have and inform your practice, but it’s not the only source of data and it’s not something that removes the authority and responsibility from an owner’s role.

The Long-Term Impact of a Feedback-Rich Environment

If you’re consistent about creating a feedback-rich environment, the long-term payoff is huge.

• Better Retention
  Employees who feel heard are more likely to stick around. It really is that simple.

• Higher Productivity
  Also relatively straightforward. Having open and honest communication makes it easier to fix problems early (nipping problems in the bud, remember?), and this leads to better overall streamlining and efficiency.

• Stronger Culture
  Probably my favorite impact. Your practice culture will grow into or become a place of trust and transparency, where people believe what they see and speak up when they notice things - this all points to having a team of people who are not surviving a workplace, but really thriving and loving their experience.

Will you just join already?!

Implementing feedback can be fun and reap major rewards, but it’s also hard to do alone when you might feel overwhelmed to start and/or unsure about where to tackle this ‘problem’ first.

I can guess where you are with things - you keep trying to figure shit out on your own, saying things like, “I can do this by myself. I don’t know who to trust to get information. It’s not doing it, it’s just the time it takes that slows me down. I can google anything I need to find out. Why would I waste my time/money/energy on a membership?”

I know those things because I was that person. At some point, I finally realized (and embraced) that I could decrease the amount of time I spent figuring shit out, increase the number of meaningful connections with other group practice owners, and save money via getting answers quickly.

I’m saying this to you so that you can learn from my mistakes (and also my methods - #Heyo)!

If you’re ready to build a culture where feedback is the foundation for success, then join us! The Practice Culture First Membership will get you access to more tips, tools, and strategies to create a thriving, feedback-rich group practice. Not only can you access feedback-oriented trainings, but you can also ask questions (and get answers) in real time during our monthly, live Q&As or via our private Facebook group (members only).

Cheers to making our practices awesome!

About the Author

Dr. Tara Vossenkemper is a gently-candid consultant who’s been in the trenches of group practice ownership since 2017. With a hearty blend of depth, irreverence, and a solid dash of humor (or so she hopes), Tara helps practice owners navigate the can-be-messy process of hiring, culture-building, vision generating, people-y issues, and all the other things that keep you up at night. When she’s not consulting, she’s probably wrangling her animals or homeschooling her kids—because why not add more chaos to the mix?

Ready to dive deeper into practice culture? Join the membership and get access to the tools and insights that make thriving, sustainable practices more than just a pipe dream.