Build a Culture of Integrity: 4 Steps

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The recent Bayer Veterinary Care Usage Study1 highlights the critical need to develop new, innovative strategies.

These strategies must address the “6 key factors that limit visits” by better tracking and metrics, communicating the need for care, managing pricing and communicating value, becoming “cat-friendly” and making appointments easier. This study reveals that practice finances depend on the team’s commitment to innovative strategies, particularly ones which engage current and future clients where they need us.

The Bayer study not only assesses the factors affecting veterinary practice success. It also provides an excellent template to address those factors and needs as well as thoughtful insights on the future industry of veterinary practice.

And while financial health is the cornerstone of the successful veterinary practice, there is an equally-important, often-neglected, element of practice success—‘cultural well-being’, or the state of harmony within the practice team extended to all whom the practice engages. This includes the patients, clients, and communities served; industry partners, associations, agencies, and organizations with which your team collaborates. Simply stated, cultural well-being is a measure of the integrity of the practice.

Why Does Integrity Matter?

In a survey of employees of Bristol Hotels and Resorts designed to measure how employee perceptions of behavioral integrity affected hotel profitability, Tony Simons reported in The Integrity Dividend2 that “behavioral integrity came out as the single most powerful driver of profit.” The results showed that a “one-eighth of a point difference between two hotels in the average employee behavioral integrity ratings pointed to a difference in profits of around 2.5% of revenues,” or, translated into increased profit on an annual revenue of $10 million, “profitability could be expected to increase by $250,000 per hotel per year.”

Tony Simons also reports that closer observation revealed a positive impact upon employees who reported high integrity on the part of their managers. He discovered:

  • deeper employee commitment, leading to...
  • lower employee turnover, and
  • superior customer service; all resulting in...
  • higher profitability.

Serving a Higher Purpose…Even Without an Oath

Organizational leadership now recognizes that most employees, no matter their role in the company, seek work that provides purpose and a sense of accomplishment. Practice employees, too, seek meaning in saving lives, and enriching human lives even if some haven’t taken oaths. But, in the glitter of gold that is the free market economy and the dullness of steel that is the bottom-line, the luster of higher purpose is diminished. In these unsettling, disordered times, which way is up? Noted productivity consultant Dennis Waitley states, “You must consider the bottom line, but make it integrity before profits.”

So what is integrity? It is the choice to live a life of higher purpose as an end in itself. An amusing story of Mahatma Gandhi helps illustrate this choice and purpose: a boy with diabetes w obsessed with eating sugar. His worried mother scolded him. Frustrated, she brought him to see his idol Gandhi. Mother and son walked miles under scorching sun, and after long hours awaiting an audience, the mother pleaded, “My son eats too much sugar. It is not good for him. Please advise him to stop.” Gandhi listened and replied, “Please come back after two weeks. I will talk to your son.” Puzzled, the woman and her son went home. Two weeks later they returned. Gandhi said to the boy, “Stop eating sugar! It is not good for your health.” The boy nodded. Puzzled, the boy’s mother asked, “Why didn’t you tell him that two weeks ago?” Gandhi smiled and said, “Two weeks ago I was eating a lot of sugar myself.” This is integrity lived!

Four Steps to a Culture of Integrity

1. Mission
2. Code
3. Expectations
4. Staff Meetings

Although these four steps are easily understood, here they need a greater explanation for the sake of clarity and context.

1. Mission:

  • “If you don’t know where you’re going, any road will get you there,” Lewis Carroll once said. He meant, to nowhere—and he was right!
  • Develop a mission statement, which must be a team event where every member of the practice team has the opportunity to express their higher purpose and needs, and to be heard.
    • The mission statement is a clear statement of purpose that says to staff, to clients and to the community the practice serves: “This is what we believe in and how we consistently adhere to the highest standards of care in our patients’ and clients’ best interests.”
    • The mission statement should differentiate and brand the practice.
    • It should be a brief, but strong statement using positive verbs of action, avoiding ambiguity or disingenuousness.
    • The mission statement should be posted conspicuously in key areas.

2. Code:

  • In a team meeting, collectively determine words that best describe your team’s harmony (write them out for all to see with a paper easel and a marker), and have everyone agree to use those words whenever possible.
    • The practice code is the charter, or commitment, of each member of the practice team to every other team member equally, and to the practice itself, by which the team functions.

3. Expectations:

  • “Integrity has no need of rules,” Albert Camus once said. But all teams and organizations need an understanding of the expectations and standards at your hospital.
  • Regularly communicate those standards and expectations.
    • Employees are highly motivated by expectations that empower them to act, and conversely are inhibited by excessive and overbearing rules that imply mistrust and assume   incompetence. Rules must be absolutely necessary, should complement expectations, and remain relevant to your practice.

4. Staff meetings:

  • Criticizing the cost of staff meetings is like criticizing the value of annual wellness exams and preventive care in front of clients.
  • Schedule regular discussions of projects and protocols, with laughter and fun included. Ask, “What do you think?”
  • Make it a pizza party, or have Suzy the front desk staff bring in her famous chocolate chip cookies!
  • Open the books at least once a year.
    • Sharing non-sensitive financial information with employees regularly:
      • Helps to build trust between employees and managers
      • Involves the team in solving financial problems
      • According to author Jody Heymann in her Bloomberg Businessweek article Increasing Profits by Opening the Books3, “Financial transparency and giving workers at all levels a direct stake in a company's success can help boost efficiency and earnings.”
  • Today’s visionary leader recognizes that all employees are integral to practice success, and respects, appreciates, and empowers each one.

Finally, views very similar to those discussed here are held by successful business leadership strategists such as Starbucks’ Howard Schultz, organizational consultant Warren Bennis, Berkshire Hathaway’s Warren Buffett, and Southwest Airlines’ Herb Kelleher. Though these philosophies might appear suitable only to giant companies and world-famous leaders, your similar commitment to developing new habits with your team will help make the shared voyage successful.

Ultimately, it is just a choice. As Henry Ford once said, “Whether you think you can, or whether you think you can’t…you’re right.”4

Please read with an open mind, and if you have questions, get back to me in about a month. I still occasionally eat sugar.


1. Executive Summary of The Bayer Veterinary Care Usage Study. Volk J, Felsted K, Thomas J, et al. JAVMA 238(10):1275-1282, 2011.
2. The Integrity Dividend. Simmons T—Jossey-Bass, October 2008.
3. Increasing Profits by Opening the Books. Heymann, J. Special Report, Bloomberg Businessweek, September 2010.
4. goodreads, Henry Ford > quotations, May 2012.

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Veterinary Team Brief delivers practical skills for team-based medicine—with clinical strategies for team training, peer-reviewed credibility, concise content, essential training modules, and easy-to-implement protocols. From the publisher of Clinician's Brief.