Follow the Leader


As physical therapy practice owners, we have the responsibility to help the next generation of therapists achieve success. This requires a learning process for us.

By Phyllis Levine, PT, DPT

The owner of a physical therapy practice is typically responsible for the management of the practice but this does not make them a leader. A manager is someone who is process driven while a leader inspires, energizes, and motivates. Many of us are probably content just managing; however, those who wish to lead need to be trained. We, as physical therapists, are educated to serve our clients. If we have the privilege to be in a leadership role, I feel we should aspire to be servant leaders and be educated in this process. Most experts in leadership believe that leaders are made, not born. Only a recognized leader who can “walk the talk” can develop other leaders. This has two obvious implications for those of us in a position to positively lead staff in our physical therapy practices. First, we must fervently strive to improve our leadership skills by modeling ourselves after those who excel in leading and then by becoming a role model for our staff. Second, we must recognize the incredible responsibility we have to lead the next generation of physical therapists in the ethical and moral development of clinical and professional skills. To accomplish this we must know what specific needs exist in our staff that require further development. Performance appraisals should be utilized to identify those needs. We, as the team leader, have a responsibility to lead them to a higher level. Our physical therapy curriculum gives us little education in this topic. Fortunately, the business literature has many examples of good, even great, leadership and the development process required.

John Maxwell, a recognized leadership expert and author, defines a leader as someone who has followers.1 Without followers there can be no leader. However, the key to becoming effective is not to focus on making others follow you but to make yourself the kind of person that others want to follow. One does not become a leader solely by rank, privilege, position, title, or income. The right to lead requires the development of trust that you will lead in a direction that the followers want to go. Maxwell delineates the components needed to achieve this trust. First, he feels one must let go of their ego, not being driven by personal gain but by the opportunity to serve others. He feels that the leadership role must be preceded by being a good follower. Positive relationships must exist in all directions. A leader must work at the highest level of which they are capable, as mediocrity does not produce respect or followers. Discipline, and not emotion, should govern all decisions especially in times of stress. There must be an overall goal of adding value to the followers. It is well recognized that the best leaders empower others, thus extending the leader’s scope beyond their immediate grasp.

Servant leadership was best defined by Robert Greenleaf.2 He felt that a servant leader is first a servant and then, by conscious choice, becomes a leader. This is in distinction to one who aspires to be a leader first. Historically we recognize examples of servant leaders in Mahatma Gandhi, Jesus of Nazareth, Martin Luther King Jr, and Mother Teresa. Present-day well-known examples are Sam Walton, Nelson Mandela, and Jimmy Carter. The common thread of all is that they led by example, wanted to improve the life of the people they led, and were not driven by their own ego. The results achieved were sustainable. This often requires a change in organizational hierarchy. The traditional model has been autocratic with management at the top and labor at the bottom. In servant leadership, the staff is at the top. This model keeps the staff happy, which makes customers happy, which brings them back. The result is success.

Several other leadership experts agree with these basic points. James Kouzes and Barry Z. Posner wrote The Leadership Challenge,3 first published in 1987. They describe the responsibilities of leadership including modeling of the way to inspire a shared vision for the staff. They feel that the freedom to challenge the process should be welcomed at any level, but that once a decision is reached all must support it. The process must enable others to act toward the shared goal and result in an atmosphere where victories are celebrated in a spirit of community.

Yet another recognized expert in this field is Jim Collins.4 He describes himself first as a student, then as a teacher of leadership and what makes great companies tick. His research in this arena gives us several takeaway points to use in our roles no matter the size of our companies. His data supports the earlier teachings of Maxwell and others. He feels that those who are successful in their business are leaders who can channel their ego away from themselves and toward the goal of a great company. This does not mean that they do not possess egos but that their ambition is centered on the organization and not themselves. However, humility and modesty are not the driving forces. An almost stoic determination to do whatever is needed to make the company great is what is recognized as being most influential.

So, how can we take these teachings and apply them to our therapy practices and staff growth in particular? John Kotter speaks to needed components for staff growth.5 In a simple summary, he states that all people involved must be aligned with unwavering commitment to the vision, mission, and direction of the practice. There must be motivation to inspire and energize people with assignments that are both challenging and broadening.

Jim Collins’s Good to Great model addresses this topic also.4 He feels that the emphasis on growth needs to be initially on “who” and then on “what.” He speaks of getting the right people on the bus, while the wrong are ushered off. The right people are then placed in the right seat. He feels that it is not people that are a company’s greatest asset, but the “right” people. Goal setting must be clear and always framed by ethics. Leadership and ethics intersect at many junctures. Leaders must set the tone and then adhere to high ethical values.

This is an expansive topic, and I have just skimmed over some well-known authors regarding the issue of leadership development and staffing. All of these leadership experts emphasize that it is our responsibility to train our successors for success.

Take Away
Perhaps the most useful recommendation I can give would be to say that if you think of yourself as a staff leader, not merely a manager, there are implicit responsibilities one must address. I encourage further self-education in the development of a leader, and the authors referenced in this article are an excellent starting point.


1. Maxwell JC. Developing the Leader Within You. Thomas Nelson; 2005.

2. Greenleaf RK. Servant Leadership: A Journey into the Nature of Legitimate Power and Greatness. Robert K. Greenleaf Center for Servant Leadership; 1991.

3. Kouzes JM, Posner BZ. The Leadership Challenge. Wiley; 1987.

4. Collins, JC. Good to Great: Why Some Companies Make the Leap and Others Don’t. HarperBusiness; 2001.

5. Kotter, JP. Leading Change. Harvard Business Review Press; 2012.

Phyllis Levine

Phyllis Levine, PT, DPT,is a PPS member and owner of Functional Therapy and Rehabilitation, PC, in Homer Glen, Illinois. She can be reached at

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