Changing demands in healthcare, new leadership structures and physician preferences on work-life balance have made culture, teamwork and engagement vitally important for the long-term success of medical practices. With recent emphasis placed on culture, teamwork and engagement, leaders have had to acquire management skills that extend beyond the scope of being a successful clinician, educator and researcher. Over the last two decades, experts throughout the business and medical fields have worked to define culture. Furthermore, these authors have shown that success in businesses is often rooted in a strong organizational culture. Large surveys have confirmed that physicians value culture. They may join or leave a practice based on the culture. Furthermore, creating, defining and preserving culture requires leaders to be exemplary citizens and to inspire colleagues to be engaged. Practices and businesses that have been shown to have a strong culture with engaged employees form stronger teams which ultimately confers a competitive advantage. In the current era, culture fit should be considered during any hire. An organization's unique culture actively needs to be taught and cultivated by leaders. Employees will become more engaged and adopt a practice's culture with education and by following the example of others.