Culture in Compliance

For years, we have talked about the culture in healthcare, especially for compliance purposes, but for many practices, that culture takes a backseat despite continued guidance.

Culture is one of the most important features of a medical practice, and for compliance programs, it is the number one way to protect the organization. You can have a policy for everything, but if your culture isn't in order, those policies will never be effective.

As a compliance consultant, here are a few issues I see, as well as items that frequently get punted to me for help:

Marketing – You can throw money at trying to bring in patients, but are you spending it the right way? When spending money, you need to ask yourself the question, "Why?" Why are you spending it and what will it bring?

Instead, work on culture. If you build a culture of excellence where the staff feels empowered and patients are treated with empathy, marketing money almost becomes obsolete. When you create a positive culture, word-of-mouth advertising explodes. When you create a center of excellence, the risk of whistleblowers dramatically goes down. When you create a culture of empathy, your reviews go up.

So, the question should then become, "Why am I trying to pay for a referral?" With the right culture, you are taking yourself away from the mindset that you have to find a way to give gifts or dinners, etc. to one of creating a practice culture that patients and employees love. You will succeed without having to worry about where your patients will come from, because the quality of your care will drive them to your practice.

Adherence to policy and procedure – You can use the stick, or you can drive culture. When employees see the C-suite and the providers engaged in compliance, the paradigm shifts. When you work on creating that engaging culture, rules are followed naturally. You cannot build followers in compliance unless you demonstrate leadership. If you cannot master leadership, you will never succeed in compliance; no followers means no adherence. You must work on becoming influential to gain trust, loyalty, and ultimately buy-in from all. If you have to use a "stick" (punitive), staying compliant will always be a shortcoming.

Training – Creating a culture that is known for its training is not an overnight feat. It takes time, but you reap amazing rewards. Individualize your training as much as possible. Don't just make a policy and stick it out there in the universe. Be sure to get it to the right people, and don't assume that just because they read the policy that they understand it. Make a short PowerPoint on the policy and record a training on the policy. It's quick and easy to do; you can use Zoom or other platforms to record and then simply upload it to your training platforms and roll it out. These short trainings are effective, to the point, and they don't require a lot of anyone's time all at once.

Working on your culture takes time and it requires you to have effective communication strategies. It also requires you to have an in-depth understanding of the personality styles you are working with so that your communication strategies are effective. This can easily be accomplished by personality assessments. I use them for clients that I work with because it helps me get to know them quickly, as well as understand then how they will learn the best. This enables me to develop training programs that they will get the most of. The cost is minimal, but the rewards are tremendous when you are working on building that culture.

Rhonda Buckholtz, CPC, CPMA, CRC, CDEO, CMPE, CHC, COPC, Owner, Coding and Reimbursement Experts. Rhonda has more than 30 years of experience in healthcare, working in the management, compliance, and reimbursement/coding sectors. She has over 15 years of practice management experience in multiple specialties and is a lean six sigma greenbelt. Rhonda was responsible for all ICD-10 training, implementation, and curriculum at AAPC and has authored numerous articles for healthcare publications and spoken at numerous national conferences. See: