Photo credit: Getty Images. Dr. Fishbein says practice culture can be defined by moments you wish hadn’t happened.
Defining your practice culture—as you want it to be defined
By Bethany Fishbein, OD
August 13, 2025
Hopefully, by the time you read this, it’s already old news. But as I write, I can’t open social media without seeing stories, videos, photos and memes about former Astronomer CEO Andy Byron and the company’s head of human resources, Kristen Cabot (not his wife, though he does have one), caught in a romantic moment on the Kiss Cam at a Coldplay concert.
They didn’t realize the camera was recording, but it was.
What was supposed to be a private moment suddenly became extremely public. It exposed not only their relationship, but also sparked a wave of comments about the ethics and integrity of these leaders and the company they represent.
It reminded me of that saying — character is what you do when no one is watching. Or in this case, when you only think no one is watching.
Culture Isn’t Built by PowerPoint
Culture isn’t defined by your mission statement or the words you recite at staff meetings, or the sign on your wall that a consultant told you to hang up. It’s not about the bullet points you use in your employment ads or the blurb in your new hire manual.
Culture is built quietly, in the in-between moments that happen all week and feel like no big deal.
Like…
- How you treat a patient who has a heavy accent, struggles to understand or asks you to repeat yourself again.
- Whether you take extra time to do additional tests or discuss preventive care, even when you’re running behind.
- How you talk about patients once they’ve stepped out of earshot or left the office.
- How you respond when a staff member makes a careless mistake.
- When a patient complains, whether you look for someone to blame or take responsibility for the problem.
- How you handle private HR issues.
- What you do with information a staff member shares in confidence.
You don’t build culture during the big, planned moments. It’s in the small ones that you show who you really are.
You might not have a stadium full of people watching, but trust me, someone usually sees: your patient (or the companion waiting for them), your reps, your manager, delivery drivers or the new employee still figuring out what kind of company they’ve joined.
Even if no one else sees, you do. And that matters too.
The Quietest Moments Speak the Loudest
Astronomer’s now-former CEO didn’t lose his job because the company was underperforming or because of something controversial he wrote online. The second that Kiss Cam footage hit the internet, though, his behavior — and what it showed about his judgment, boundaries and leadership — became the story. It just took a few seconds.
Your patients, your vendors and your team are always forming impressions based on how you act in those in-between moments. No team-building event, staff meeting speech or polished email can erase what people see when you’re simply going about your day and your guard is down.
Who Are You Off Camera?
You don’t control which moments define you. But you do control the kind of person and leader you want to be.
So next time you’re in one of those “no one is watching” situations, ask yourself: If someone recorded this and posted it all over the internet, would I be proud of what they saw? Or, even better, if my team acted this way when I wasn’t around, would I be proud of what they learned from me?
Because that’s what culture is. It isn’t what you say — it’s who you are. Not just when you’re polished and prepared for a meeting, but when you’re tired, frustrated or under pressure.
That’s what people remember. And that’s what lasts.
Read another recent column by Dr. Fishbein
Bethany Fishbein, OD, is a practice owner, practice management consultant and certified executive coach. She can be reached at bethany@leadersofvision.com
