Nothing in life brings us more face-to-face with ourselves than owning a business. Things like sports, schooling, marriage or raising children don’t cause us to confront who we are, what our strengths and weaknesses are, and what drives us quite like business ownership. It acts as the perfect amplifier of our skills, motivations, self awareness, thirst for knowledge, ability to communicate, tenacity, planning, leadership and team-building abilities because there is no such thing as a no-fault business.
Consequently, the demands placed on practice owners are huge. And this is never more true than in a growing practice where the title of “owner” can soon mean “chief everything officer.” As patients are gained and employees are hired, often expectations are unclear, accountability is weak, feedback and appreciation is lacking, systems are created by default, what was once simple becomes more and more complex–and it appears the only way to confront these dynamics is to tighten the grip even more. Employees then fall into two camps: over-performers who are burnt out and unhappy, or underperformers who are entitled and unhappy.
Along with the ever-constant cash flow worries, there is the fear of failure—and paradoxically—the fear of success. The mounting stress cannot even be escaped at home, but is only momentarily numbed through mindlessly surfing the web or watching a sitcom late in the evening. It seems there is never enough time or energy to get everything done. The hope that launched the practice seems to fade into the background as the personal and organizational stressors grow. As the chaos mounts comes a mid-night cry from within: “I want my life back!”
Trying to hold on, it is common for practice owners to resort to what I call the Seven Deadly Sins of Management:
- Issuing threats and ultimatums
- Comparing to prior staff members
- Consistently being inconsistent
- Not backing their team
- Micromanaging and not prioritizing
- Breaking confidences and creating “drama triangles”
- Being chronically negative
But there is a way out of this, and it is called leadership. Specifically, it’s a way of leading that flips a practice owner’s focus to become the leaders they have always dreamed of becoming.
The Leadership-Business Success Connection
In times of chaos—and in times of stability—there is an unmistakable connection between leadership and business success. In times of chaos, leadership is the single greatest element that can successfully pull the group through to get to the other side. And in times of stability, leadership provides the clarity of purpose and direction, while creating a culture that is largely self-sufficient and self-sustaining—as the practice thrives.
Why is leadership is required for practice success? To begin with, as human beings whether it is by nature or nurture, we are hierarchical beings. Social structure is a part of our makeup and we look to leaders for fundamental activities. The first is to set the vision and direction. In my work, I have found everything else a leader does—besides their personal highest and best purpose—can be delegated except for vision and direction. No one else can do this. No one else can set the course, shape the direction and create the compelling vision of where a group is going and why.
There is a third fundamental element leaders are also wholly responsible for, whether knowingly or unknowingly, and that is setting the pace. Pace is the internal rhythm, sense of urgency and rate things are accomplished. And the pace of a group is a direct reflection of the leader’s very own pace. Teams cannot run faster than their leader. It is impossible to do.
Acknowledging this connection between leadership and success can be a frightening truth, or the most liberating thought ever for a practice owner. When a leader accepts responsibility for their own situation, their own development, and then decides the time is now to begin to raise the level of their game and create change within themselves so change will happen in their organization, amazing things take place. For a practice owner, personal development is the key for organizational development. And like a pebble being dropped into the pond, the ripple effect is real and profound.
Traditional Top-Down Leadership
Let’s define what I mean by an upside-down leader. This management model is best understood through contrast. Ask the average owner what leadership and business looks like and you’ll likely hear a description of the traditional organizational pyramid. Indeed, most practices resemble this top-down structure. At the pinnacle of this pyramid is the owner/doctor. Everyone lower than them ultimately exists to see the person at the top succeeds. Leaders in this traditional organization view their role as being a boss, giving orders, issuing commands and making things happen because no one else in the practice cares or knows as much as they do.
But operating in this structure brings a host of problems for the leader, to say nothing of the underlying employees. Chief among these problems for the practice owner is the tendency to burn out. As we discussed earlier, being a “chief everything officer” is exhausting. When a practice grows, so too do the demands and to-do list of an owner who is trying to hold fast to the reins. Often, health and family life take a backseat to work. Yet despite the efforts of the leader to create a successful business, the workplace culture is unstable and, frankly, sick. Morale is low, turnover high. The question that wakes these business owners up in the middle of the night is, “Isn’t there another way?”
The answer is a resounding “Yes!” Upside-down leadership allows practice leaders to support their team in becoming their best, provide vision while setting the pace of their organizations and create a business and life of significance—while being successful and having balanced lives! As leaders and their teams flip their frame of reference from control to abundance, from top down leadership to upside-down leadership, with clear expectations, clear roles and goals; and with the end goal to create a self-perpetuating culture of unselfish teamwork—the results are life changing personally and professionally . Upside-down leadership is the answer to the midnight cry for help, because it transforms a business from being owner dependent, to organizationally and culturally dependent. CEO then means “chief empowerment officer.”
What does it look like to flip your focus from a traditional leadership perspective to a model of upside-down leadership? The changes are dramatic:
- From boss to coach
- From fear to freedom
- From focusing on survival to success and significance
- From scarcity to abundance
- From chaos and confusion to clear expectations and accountability
- From perfection to excellence
- From a culture of control to a culture of participation and ownership; from director to facilitator
- From individual employees to becoming a team
Flip Your Focus … and Change Your World
We’ve seen the results of the traditional top-down organization. Arthur R. Jones once said,“All organizations are perfectly aligned to get the results they get.” Paraphrasing this slightly, I believe every leader is perfectly aligned to get the results they are getting. And what type of results has top-down leadership created in America today? Statistics show 70 percent of employees will admit they are not engaged at work, while a staggering 17 percent are actively disengaged and regularly sabotaging productive work. When success is all about the person at the top, those who want to contribute their highest and best will check out of an organization—and most those who don’t leave have already quit their jobs; they just still get a paycheck.
But there is another way. And what it takes is to flip your focus and way of thinking about leadership. Take that traditional organizational triangle and flip it over in your mind, and don’t let it move. This is how upside-down leaders think. Differently. Rather than everybody existing to see that the person at the top succeeds, in an upside-down organization, the leader or leadership team exists to see everybody in their organization succeeds. These leaders have a long-term focus and strive to empower their team knowing true empowerment achieves miracles. They are committed to surrounding themselves with the very best and the brightest talent, knowing their job is not to have all the answers … but know how to facilitate and pull the answers out of their team. And they lead from a standpoint of hope, not fear. The seven deadly sins are clearly on their “To-Don’t” list. In fact, they do the opposite. They know their job is to help everyone in their organization to do their best and be their best . Their list looks like this:
- Coaching with hope
- Believing in each person
- Being measured and consistent
- Supporting their team
- Empowering and prioritizing
- Creating a culture of trust, responsibility and accountability
- Finding the best in people and situations
As a leader or owner accepts this mindset and leaves the top-down culture forever in the dust, the success that takes root and then occurs within their organization is exponentially greater than in a traditional organization.
Upside-down leaders look at business from an entirely different perspective. Of course, they are running a business and are aware of the bottom line, but that doesn’t drive their every action. Their bottom line is the result of consistently doing the right things. Indeed, they have a more organic approach—focusing not only on operations, but also on the people who work for them. That flipped focus naturally leads, and even surpasses, their desired outcomes. You don’t build a business. You build people, and then people build your business,” Zig Zigler once said.
Leadership can be mastered. Often there is a question of whether leaders are born or made. I don’t agree with either question. The ability to lead is found from within through the process of committing to personal change—looking succinctly and honestly in the mirror and coming to the realization that whatever it has taken to get you where you are, it is not going to be enough to get where you need to be. So, assess where you are right now. Evaluate the culture of your business. Between the two choices below, circle the one that most accurately describes what you see going on today. Be totally honest.
Contention or collaboration.
Finger pointing or accountability.
Burnout or fun.
Fear or hope.
Scarcity or abundance.
Entitlement or Empowerment.
If you circled three or more words on the left, don’t get discouraged. You are in good company because most practice cultures look and feel like this. If you scored three or more on the right—you are already on the path of an upside-down leader.
Stop what you are doing now and list some concrete goals to start from wherever you are—to get to where you want to go. Make some very clear commitments. With these commitments you will find a desire to be coached. All great athletes and performers have coaches because all of us have blind sides. It is impossible for us to see fully everything we need to see to continue to have further success and improvement. My new book will be a start to that coaching. Other books can help begin the process, as well, including Stephen Covey’s Seven Habits of Highly Effective People, Jim Collins’ classic Good to Great and a little volume from Dr. Timothy Clark called The Leadership Test. Above all, remember, “If nothing changes, nothing changes.” Start that change process today to becoming the leader you’ve always wanted to be. You will reap the rewards.