Once More into the Breach – Setting and Managing Leadership Boundaries

By Ingrid Sparrow PT

As a clinic owner or manager, you likely have many roles: treating physical therapist, human resources manager, financial steward, marketing guru, facility and supply manager, and friend or mentor, to name a few.

It is thus not a mystery that you feel you are being pulled in multiple directions on an hourly, daily, and weekly basis. Taking the time to define and communicate each role and its boundaries can help you be more efficient, less stressed, and more satisfied with your job.

However, establishing boundaries can be difficult for both you and your staff. Boundaries are, at times, perceived as being negative, a barrier to accessibility, or an unwillingness to communicate or be of help. And for some, articulating boundaries can be difficult as they do not want to be seen as selfish or unlikeable.1 You have likely experienced both of these situations. You would like to do as much as you can for that special patient or employee, but you also want to eat your lunch and finish your paperwork before going home. If you have not established your boundaries, your “ability to focus and prioritize falls by the wayside in favor of a more social environment where few are able to actually meet their goals.”2 And at the end of the day, no one is satisfied with how their day and interactions concluded.

It can help to consider that while you have many roles in the clinic, your work boundaries generally fall into three categories: job responsibilities, interpersonal boundaries, and personal boundaries.3 Viewed like this, you have just three categories to manage!

Job Responsibilities

These categories are needed for both managers and employees as they define both work responsibilities and accountability: who assigns and gives feedback on work, who reports to whom, and what are the expectations regarding communication on projects and conflicts.

Interpersonal Boundaries

These are often described as work culture or values. What are your expectations as to how co-workers treat each other, and have you effectively communicated these? Is respectful communication the norm and modeled even in the face of personal conflict, or is there eye-rolling and half-completed communication without a path to resolution? Creating and cultivating a culture of effective interpersonal boundaries strengthens communication and contributes to a more effective workflow. A simple tool used by many companies is the expectation that each employee will greet each other the first time they see each other for the day. A small but simple way to build bridges and make connections before we dive into our busy days.

Personal Boundaries

This is the ever-elusive work-life balance—setting the boundaries between you and your work. And what constitutes these boundaries are as individual as we are. Some of us prefer to have set schedules and processes while others prefer to address items as they arrive. Of highest importance is that your boundaries support and reflect your values and that they are clearly communicated to all of the staff so that work is done in the least stressful manner for all employees, not just you.

In addressing your personal boundaries, it can be helpful to identify how and when your boundaries are most commonly tested, how this makes you feel, and then respond. Determine what is needed: stronger boundaries, better skills at managing your boundaries, or more frequent or consistent communication. Universally agreed-upon is that boundaries will be breached and this is not necessarily your fault! Realize this and have strategies and dialogues in place and practices that support your boundaries. This applies not just to you, but also to your staff, so having individual and group discussions are important to reinforce agreed-upon boundaries.

A common example of this is patient-staff boundaries. One of the harder tasks as a new physical therapist is learning how to provide excellent and empathetic care while maintaining a professional boundary. Most of us have learned the hard way that if we do not learn to do this, we are at risk of letting our patients become “energy vampires,” draining us of both energy and time, making us less available for our other patients, staff, and family. This is not a skill most new administrative staff have developed. We coach them in this, especially those who enjoy providing excellent customer service. They will often try to do everything they can to help a patient but in the process blur the boundary between the responsibility of their job and the responsibility of the patient. Yes, they could call the doctor’s office asking for that prescription, or they can be coached that this really is the responsibility of the patient.

This week, look at your boundaries and ask whether they reflect your values and whether they are working effectively. As needed, align them with your values and develop a strategy for discussion and change. Author Rachel Goss recommends the following steps for these difficult conversations4:

  1. Describe your situation, using “I” statements and share the feeling you are experiencing in the situation.
  2. Express what you would like to happen instead in this situation.
  3. Share what the positive effects of the new situation will be.

Well-defined and understood boundaries allow each of us to feel more supported and more effective with our lives both at work and at home.


11. Henkel JK. How to set and maintain healthy boundaries as a leader. BizCommunity. https://www.bizcommunity.com/Article/196/610/208456.html. Published Septebmer 17, 2020.

22. Rabban A. How Your Team Can Set Effective Boundaries. Score. https://www.score.org/blog/how-your-team-can-set-effective-boundaries. Published January 25, 2019.

33. Criminal Watch Dog. Why You Need to Set Boundaries at Work & How to Do It. https://www.criminalwatchdog.com/resources/skill-development/setting-boundaries-at-work/. Accessed December 10, 2021.

44. Goss R. 3 Steps for How to Communicate Boundaries in Relationships. INLP Center. https://inlpcenter.org/how-to-communicate-boundaries-in-relationships/. Accessed December 10, 2021.

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