Nurturing A Positive Practice Culture
Dr. Betsy Grunch, known online as LadySpineDoc, isn’t doing it alone.
In this honest and insightful talk, she shares what it really takes to build a practice culture that’s not just high-performing, but joyful.
She talks trust, connection, and the power of having each other’s backs while doing big, meaningful work in neurosurgery.
This talk is available in full—and free to watch for CE/CME credit—on the Learn at Pinnacle app (👉 learnatpinnacle.com/education). You’ll also find more powerful content from speakers you already love.
Other topics covered in the full talk include:
Tips for onboarding staff with empathy and purpose
How to lead without shame and reduce medical errors through open communication
Creating structured time for feedback and one-on-one check-ins
The power of storytelling and video in team education
Creative hiring strategies that protect team culture
Why Valuing Your Team is the Foundation of Culture
In a powerful moment during her Pinnacle talk, Dr. Betsy Grunch shares, “31% of people leave healthcare because they don’t feel valued.” That single insight sets the tone for everything else she shares: team culture isn’t a bonus—it’s essential for patient care, staff retention, and even personal well-being.
The hidden driver of burnout: not being seen
While burnout and long hours are often blamed for healthcare turnover, Dr. Grunch highlights something deeper: disconnection and lack of appreciation. If team members feel invisible or dispensable, morale, and quality, suffers.
“Everyone is valuable. If they don’t feel valued, they will leave.”
This understanding has shaped how she leads. She doesn’t just see her team as employees, but as co-contributors to healing and innovation. That includes everyone—PAs, MAs, front office staff, surgical techs, even vendor reps.
A ripple effect on patient care
Dr. Grunch makes the powerful point that the patient experience starts long before the physician walks into the room. Every staff interaction contributes to the overall culture patients feel and trust.
“If the front desk is rude, patients associate that with me.”
For any practice leader, this is a call to own the full spectrum of your team’s interactions—not micromanage them, but empower them to reflect the values you want patients to experience.
A mentor's influence
During residency at Duke, Dr. Grunch watched her mentor, Dr. Carlos Bagley, do something small that left a big impression: he bought lunch for everyone in the OR. No big speech. No agenda. Just a quiet way of saying—I see you. I respect you.
It stuck with her. Because when people feel valued, they show up differently.
That’s how she leads now. Not as “the boss”—but as the team captain.
How to Build, Train, and Lead a High-Functioning Team
In building her team from scratch, Dr. Grunch didn’t just look for resumes—she looked for alignment. She spent four months finding her first PA, Erica Abney, because she wanted someone she vibed with. “Best decision I ever made,” she reflects.
Hiring isn’t about speed. It’s about fit.
“Don’t just fill a seat—find the right fit.”
Instead of rushing to fill gaps, she identifies talent slowly, even recruiting people already in the ecosystem—like medical assistants from shared office spaces or scribes who fit the culture naturally. She jokingly calls herself a "sniper" when it comes to hiring, which makes people laugh—but her method is serious: know your vibe, protect your culture.
Ease people in—and model the standard
Too many practices throw new staff into the deep end. Dr. Grunch advocates for gradual onboarding and direct shadowing, especially in high-stakes specialties like surgery.
“Model the behavior you want. Let them see how you treat patients.”
She also emphasizes clear communication: staff need to know not just what to do, but why. Training should equip them to succeed—not leave them scrambling and stressed.
Be direct, but kind
Another leadership growth point for women in medicine: learn to be direct. Dr. Grunch acknowledges it’s not always easy.
“We don’t want to be that person... but we have to talk to people directly.”
She avoids the game of telephone through office managers. When behavior isn’t working, she handles it herself, with kindness and clarity. That approach builds trust—and keeps gossip and resentment at bay.
Keep listening—create regular feedback loops
Even when things feel like they’re going well, she holds monthly team meetings and one-on-ones. Why? Because “sometimes there are issues I don’t even know about.” Creating space for feedback is essential, especially as a practice grows.
Using Social Media and Shared Experiences to Strengthen Practice Culture
Dr. Grunch is known as @LadySpineDoc on Instagram—but her content isn’t just about her. It’s about her team.
She includes her team in videos, matchy-matchy scrub days, and even viral content. Why?
“Patients already know my face from Instagram... but they also get to see who’s behind me.”
It’s not performative—it’s authentic. Her team feels like part of the mission. And it humanizes her practice in a way that builds connection with patients and community alike.
Go beyond the walls of the practice
From Beyoncé concerts to shared birthday parties to an annual team beach vacation—Dr. Grunch isn’t afraid to invest in experiences that build real relationships.
“We all just pile into a house and have a good time.”
That might not be feasible for everyone, but the principle is powerful: Make time for joy and bonding outside of patient care. People stay where they feel seen—and have fun.
Celebrate life milestones together
Whether it’s baby showers, weddings, or surprise birthday parties, Dr. Grunch shows up for her team’s big moments—and invites them into hers.
Even when Erica, her long-time PA, left the practice to raise her family, she returned to Pinnacle to support her former boss.
“Losing her was one of the hardest things I did... but I realized it was for her personal growth. And it speaks to our relationship that she’s here today.”
Social media tip: Be inclusive and transparent
Dr. Grunch encourages making sure patients know who on the team they’ll be seeing. If a PA is doing an intake or consult, set expectations. This helps the patient feel informed, the staff feel respected, and the visit go smoothly.
Conclusion: Lead Like You Mean It
Dr. Grunch’s story is more than inspiring—it’s actionable.
Key takeaways:
Valuing your team isn’t optional—it’s essential to retention and patient outcomes.
Hiring and training with intention builds a resilient, joyful culture.
Bringing your team into your social media and life can deepen relationships and morale.
This article only scratches the surface of the full talk, which is available now for free CE/CME credit on the Learn at Pinnacle app.
Now what?
Share this article with a colleague or practice manager.
Host a team meeting to talk about your own practice culture.
Watch the full session on Learn at Pinnacle and start building a workplace people don’t want to leave.
Because when we lead with clarity, compassion, and joy—we don’t just build a stronger practice. We build a movement.
