How to Perform a Leadership Audit


We scrutinize everything but this critical component of business health

By Phil Cadman, PT, DPT

Audits can be time-consuming, but the investment is well worth the information and insight gleaned. In addition to other audits you may conduct, a leadership audit must be part of every leader’s review.


You may find that things that were working for you before no longer work because of the constant and sometimes extreme change we’re all navigating. Perhaps your company has grown, staff has changed, you have changed, and health care has changed. As a result, you need to alter what you do as a leader. While it can be lonely at the top, and your staff may not know what challenging decisions you have to make, it is important to have a way to ensure that you are leading effectively. It is also important to not just look in the mirror to make these changes because we have blind spots to some of our own leadership strengths and shortcomings. It is good to be able to have a culture where you are able to glean information from your staff in order to grow as a leader. To make these changes and ensure that you continue down the path that you want to go down, check in on five areas: your focus, actions, thoughts, words, and why.


What is your focus? Is it growing your business, developing your staff to make your business better or more distinguished from other practices, or just trying to manage through a pandemic? It is important for you to be able to identify what your focus is and clearly communicate it to your staff. The strategy that you employ to work on your focus is the step-by-step plan that puts your and your staff’s efforts in motion toward your goals.


Avoid creating unnecessary distance between you and your staff by sitting in an office that continuously separates you from regular interaction with your staff. As we all know, the physical therapy business is about relationships, and that is especially true about the relationship you have with your staff. Be authentic when you communicate with your staff. They are the reason that your business is successful. Provide opportunities for them to provide feedback to you about your performance and the company. Many of your staff will have difficulty doing this initially because it may not be something they’ve been asked to do in previous jobs, and they do not want to do something that will offend “the BOSS.” You may need to employ some tactics to get everyone talking, such as asking some trusted employees to speak up during the meeting first to help break the ice.

After listening to their feedback, act accordingly. Learn from your past experiences, and employ amended practices based on input from your team. Create a positive working environment by allowing your employees to see that their input and perspective matter to you by actively listening and then taking action based on what you have heard. Not every suggestion or procedure change has to be implemented, but you must provide feedback to your staff about why the changes weren’t made and explore alternative solutions.

In addition, demonstrating an interest and investment in your team is important. Recognize what each employee brings to the company and work toward supporting them through fostering continued growth in their knowledge and skills. Increasing autonomy in your practice and reducing micromanagement will help to foster their feeling of ownership and will ultimately improve patient outcomes and financial outcomes for the staff and company.


Comparing yourself to others is natural, but everyone’s path is different Your path is unique to you. Be consistent and persistent with the thoughts and actions you believe are leading you toward success. Take time to think, create, and work on your business. Schedule time during your normal work week, not in addition to your 40+ hours of patient care. You should not be the reason that your business isn’t growing.


Effectively communicate your vision, mission, and philosophy. You must make your expectations clear to help equip your team with the ability to see that their work directly contributes to the big picture of success and supports the vision, mission, and philosophy of the company.


Your why is what fuels the success of your business. It is the purpose that propels you forward and helps to motivate your staff. Set aside time quarterly, every six months, or once a year — whatever frequency is best for you — to evaluate, refine, and revisit your why.

These audits ensure that we are growing and changing consistently and with intention. Author Simon Sinek describes that there are no winners in the game of business because that would imply that there is a finish line. He goes on to say “Finite players play to beat the people around them. Infinite players play to be better than themselves.”1 We want to make sure that we leave our businesses and the people around us better off than before we started it. Following a plan and being intentional with what you want to accomplish as a leader is important to accomplish both of those goals. 


If you are a leader that likes checklists, I recommend the following:

action item

1Sinek S. The Infinite Game. New York, NY: Portfolio; 2019.

Phil Cadman

Phil Cadman, PT, DPT, is owner of Premier Physical Therapy Services in Cincinnati, Ohio. He can be reached at and @premierphysicaltherapy on Instagram.

*The author has a professional affiliation with this subject.

Copyright © 2018, Private Practice Section of the American Physical Therapy Association. All Rights Reserved.

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