Introduction to Leadership

Behind the curtain

Determine your strengths and how to apply them.

By Brian J. Gallagher, PT*

Leadership in business always struck me as an ambiguous concept. Many books on the topic of leadership simply list examples of common actions leaders take or particular traits they share. None of them truly explain what leadership is or describe how one can become a more effective leader through training.

I was once told that what makes an expert clinician is the combination of advanced education and years of experience. Therefore, if a newly graduated physical therapist can someday become an expert clinician from their advanced education and experiences, then why shouldn’t an owner be able to become a true leader?

However, many owners fail to recognize that their first responsibility is that of being the chief operating officer of their company and a physical therapist second. They tend to see themselves as a physical therapist who happens to own a physical therapy practice instead of the other way around: a business leader who happens to be a physical therapist. The first step in becoming a good leader is taking the correct point of view, then honing the basic fundamentals that are required for leadership.

These include: confrontation, communication, cause versus effect, personal integrity, and not seeking to be liked or admired.

The ability to confront others is basically being able to face others on any topic, while remaining comfortable in the process.

Confrontation drill: Ask two people to sit across from each other and to stare into each other’s eyes for three minutes without looking away, laughing, or getting fidgety. Just be there in front of one another comfortably, without saying anything.

Effective communication can only occur when both parties converse in such a way that it brings about a mutual understanding (this is not to say that the other person agrees with you, but that you at least understood what they are saying).

Communication Drill: Pretend that you are speaking with someone from the 1800s, trying to explain to them what an iPhone is in words that they can understand in five minutes or less.

Remain at cause versus effect: Leading is knowing what is the greater good for the group, taking responsibility for the cause, and not being afraid to create an effect in others while making decisions.

Cause and Effect Drill: Give a staff member a clear order and repeat or rephrase the order. State the deadline, and request an update at the halfway point in the task. Without the check-in and deadline, the completion rate will drop greatly.

As the business owner, your personal integrity determines not only how you act, but how your staff portrays itself to your customer. Upholding your personal integrity, even in the most difficult of situations, validates your company mission and values.

Internal leadership

Never seek to be liked or admired. This is probably the most common error owners and managers make. This would be synonymous to saying yes to everything your kids ask for, for an entire month. Yes to chocolate cake for dinner, Yes you can go to bed whenever you want, Yes you can skip school today. What do you think things will look like at the end of that month? Now apply this concept to the workplace where you are trying to make everyone happy by giving them whatever they want . . . you will get the same results.

So the million-dollar question is: Through professional training, can one learn how to display true leadership? The answer to that question is yes and no: Some people put in countless hours of training only to demonstrate minor improvements, while others have benefited greatly from even the slightest amount of training. Leadership starts internally as a personal attribute as opposed to a “doing action.” Ask yourself, when in group situations, do you find yourself more comfortable when you are in control of making decisions, or are you more comfortable following somebody else who bears that responsibility?

I ran into this myself just a couple of years ago when I was summoned for jury duty. Before I left the house, my wife told me, “I bet you’re going to become the jury foreman.” I told her, “No way, that’s not going to happen.” But by the end of the first day when the votes were counted, everyone had voted for me to be the foreman except for one person, me. Great leaders possess an attitude that says, “Hey, I’m not afraid to say what needs to be said, but I’ll always respect those around me.”

Mastering these fundamentals will greatly increase your natural abilities toward improving your leadership skills. The good news is that, just like with anything else, if you practice what is difficult it will soon become easy. If it does not, then perhaps leadership is not your forte. The bottom line is, you won’t know what you are truly capable of until you try.

Brian Gallagher

Brian J. Gallagher, PT, is the chief executive officer of MEG Business Management, LLC. With more than 24 years of experience in the field of rehabilitation and 19 years in business, he specializes in physical therapy practice billing and coaching nationwide. Brian supports the APTA through lecturing, writing articles, and performing webinars. He can be reached through his website at or via email at

*The author has a vested interest in this subject.

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

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