Enhancing Practice Performance

Leadership: More important than ever

These nine leadership competencies will help you serve your staff and patients.

Do you find yourself longing for the good old days? Can you even remember them? Back then, your biggest problems were a competitor’s new satellite down the street or a favorite technician’s resignation. Isn’t it fascinating how abruptly your perspective can change during a crisis? Your old problems now probably seem more easily solvable than before, compared to the business (and literal) survival challenges that COVID-19 sent your way.

As states reopen and allow practices to fully function again, the sighs of relief from physicians and staff are audible. It’s not too early to reflect on what we’ve learned.

In our work over the last 90 days running a “medical practice ICU,” we’ve seen every practice owner struggle with the challenge, but some have pushed through this difficult period more effectively than others. Were these the smartest doctors, those with the best staff or those with an extra cushion of cash on hand? No. The ophthalmologists who have sailed through the earliest phases of the pandemic (remember, we’re not done yet, not by a long shot) have been those with the best leadership skills. Leadership — the art of inspiring, directing and motivating a team to achieve a common goal — has never been more important in your career and practice life than right now.

Even the smallest solo practice needs a strong leader at a time like this. And larger practices need an integrated leadership team: in the boardroom, at the top of business administration and in each department.

Being a leader was hard enough in a pre-COVID world. Today, and for at least the next year or two, being a sufficiently effective leader in the midst of a rolling crisis, as new infection spikes come in waves, will challenge your best efforts. Civilians are beginning to understand the pivot that military leaders must take when their country goes to war. Think about the before and after in your own setting:

  • The people you lead are understandably afraid, angry and at least a little depressed. For example, the single mom who only made ends meet in 2019 wonders if she or a relative could become homeless in 2020.
  • The planning horizon shifts from a “10-year strategy” to “10-day tactics.”
  • Learning new skills or rules, once a leisurely undertaking, is now done on the fly.
  • The classic standard of perfection in ophthalmic circles must yield to, “Do the best you can with what you have. Nobody is going to think less of you for trying your best.”

Here is a list of nine leadership competencies that will help reinforce or add to your own skills as you keep pushing forward to serve your people and your patients in these exceptional times. As you read through this list, ask yourself how you can improve each of these skills and be the leader your practice needs at this special time.


What you may have once perceived as “over communication” is needed now. Provide daily or at least weekly updates. Check in with furloughed staff and doctors. Be open to all suggestions. Don’t let the heat of the moment keep you from bolstering verbal communication with written communication (eg, meeting minutes, new protocols and policies.)


If everything is a priority, nothing is a priority. There may be too many things on everyone’s daily task lists. Everyone in the practice had a full-time job before COVID-19 came along. Something has to give. Take time to re-evaluate expectations. As you make tough choices — often on the fly — know that you can revisit these choices and reprioritize later.


Be more decisive (“crisp” is a good word). Then act promptly. Don’t let decisions linger. If a mistake is made, it is generally better to make a mid-course correction than to have delayed taking action. It’s a little like football, soccer or basketball (Remember those pro sports we used to enjoy?). It’s a momentum game, and getting the ball downfield is more important than perfect execution.


A pandemic is no time to think in silos. Senior staff and doctors should meet more often than ever, not only to make better decisions but to align on how those decisions are going to translate into action.


Medicine is a steady trade. It’s not a boom-and-bust business like construction or banking. While no business in America pre-planned for a pandemic on this or any scale, eye clinics were especially lulled by several generations of comparative easy times. Who could have guessed in 2019 that eye clinics would be shuttered and staff would be furloughed en masse in 2020? From now on, thoughtful clinic leaders will ask, “Are we ready for the next pandemic? Have we written contingency plans for future events? Are needed supplies fully stocked? Are lines of credit in place? Are doctors prepared to forego paychecks?”


Like a good Boy Scout, being prepared for the unexpected makes unforeseen circumstances easier to handle. Work with your practice accountant and other advisers to be ready in the future. Pre-coronavirus, the rule of thumb was to have ready capital access equal to at least 3 months of core operating expenses before MD compensation. Post-pandemic, a better cushion might be 6 months or more. (Examples of capital sources: A/R in transit, practice bank accounts, lines of credit, MD-owners pledging their personal funds)


Whatever the future holds, resiliency in a crisis improves in direct proportion to the depth and breadth of your practice’s relationships with others: patients, staff, vendors, advisers, bankers. Leaders stay connected ... their relationships are “sticky.”


Having the skill to influence others to embrace change helps your team adjust to new conditions faster. As the leader, you understand that risks have to be taken and errors will occur as change occurs. Be supportive, forgiving and encouraging.


Leadership takes time, effort, self-discipline and courage. But the most trusted leaders are great problem solvers. What does that entail? The list is long, but it includes:

  • Knowing when enough facts have been gathered to make a decision — not stopping short but also not over-analyzing extraneous data.
  • Being creative in thinking through the potential options. Sometimes when you are stuck on a problem, just listing the options is enough to see the best one clearly.
  • Conflict resolution skills. The toughest problems are those existing between two people or sides of an issue. OM