Your Team Doesn't Have a Clique Problem. It Has a Communication Problem.

Most leaders would rather have a team that enjoys each other than one that can't stand being in the same room together. And generally speaking, that's a good thing.

When team members laugh together, support one another, celebrate birthdays, grab lunch, and genuinely enjoy working alongside each other, it creates a positive atmosphere that patients can feel.

But every strength has a shadow side.  Sometimes the very thing that makes a team feel connected can unintentionally create communication problems, hurt feelings, and frustration behind the scenes.

Not because anyone is trying to exclude someone. But because friendships can quietly become the way information travels.

The Difference Between Friendship and Inclusion

One of the biggest misconceptions we all make is assuming that every team member wants the same type of connection that we crave.

Some people thrive on relationships. They enjoy chatting before meetings, grabbing coffee together, and spending time with coworkers outside the office.

Others are perfectly happy being friendly coworkers. They don't need a work bestie. They don't want to attend every social gathering. They simply want to do great work and be respected for their contribution.

Neither approach is right or wrong. The problem occurs when leaders mistake social connection for inclusion. A team member may not care about being invited to lunch. But they absolutely care about being left out of conversations that impact their work.

How Cliques Usually Form

Here's the interesting thing about cliques: Most aren't created intentionally. Rarely does a group sit down and decide who gets included and who doesn't.

Instead, people naturally spend more time with those they connect with. Over time, they begin sharing information, ideas, concerns, and observations with the same people repeatedly.

Eventually, they stop realizing they're doing it. They assume everyone has the same context they do.

That's when trouble starts.

The Closed-Door Assumption

Many practices have a version of what I call "The Closed-Door Assumption"

A few people frequently step away for conversations. They gather in the lab, consult room/office, or the break room. The conversations may be completely harmless. The intent may be innocent. But perception matters.

When the same people are regularly seen having private conversations, others begin creating stories:

"What are they talking about?"

"Is this about me?"

"Did everyone know about this except me?"

"Am I missing something?"

Whether those stories are true is almost irrelevant. Perception often drives culture more than intent.

What Healthy Teams Do Differently

Healthy teams don't eliminate friendships. Healthy teams create guardrails.

They understand that friendships are wonderful, but friendships should never become the primary communication system within the practice.

Healthy teams make sure:

• Concerns are addressed with the people involved, FIRST..
• Everyone affected by a change is included in the discussion or informed directly.
• Information flows through systems, not relationships.

Most importantly, healthy teams recognize that belonging doesn't require everyone to be best friends.

A strong culture isn't one where everyone socializes the same way. A strong culture is one where every team member feels respected, informed, valued, and included in the conversations that impact their work.

 At some point, every team member has to ask:

Am I protecting the culture, or am I poisoning it?

That may sound strong, but culture doesn't usually collapse from one big dramatic event. It erodes through side conversations, assumptions, eye rolls, exclusion, gossip, and unresolved frustration.

The good news? It can also be rebuilt through direct conversations, grace, inclusion, clarity, and personal responsibility.

Before blaming "the culture," it's worth asking ourselves a few questions:

• Am I addressing concerns with the people involved or discussing them with everyone else first?
• Am I contributing to clarity or confusion?
• Am I building trust or feeding suspicion?
• Am I helping people feel included or unintentionally creating division?
• Am I making assumptions, or am I seeking understanding?
• Am I the kind of teammate I would want to work alongside?

The culture of a practice is shaped in small moments all day long.

Every team member has a choice:

• Contribute to clarity or contribute to confusion. 
• Build trust or feed suspicion.
• Have the direct conversation or participate in gossip.

Culture isn't what happens to be 'allowed'. Culture is what the team repeatedly chooses.  Choose well!