Six Steps to a Leadership Culture

Six steps to leadership culture

Create long-term success, growth, and profitability.

By Robbie B. Leonard, PT, DPT*

Most practice owners have too many items on the things to do list and not enough time to get everything done. Practice ownership may also feel like an island where the owner is the only person who cares about the long-term growth and profitability of the clinic. Creating a leadership development program that aligns and engages your team in achieving long-term success for the clinic is key in solving these problems.

Leadership development may feel like a daunting task that you don’t have time for. But before you write it off, realize it is the one item that can make a huge difference in your practice’s success, and it doesn’t have to be complicated. The following six steps can help you create a culture of leadership within your organization quickly and effectively.


Leadership development is not something you do once and put aside. It is an ongoing process that requires deliberate and long-term dedication. The first step is to evaluate the current state of your leadership team and the results that they achieve. Start with these questions (and write down the answers): How is the current leadership structure contributing to company results? Are we achieving annual goals for growth and profitability? Does our leadership team create a positive and productive culture? What gaps need to be filled and what changes need to be made?


Do you have an effective organizational structure? Are leaders empowered and do they take ownership of the results of their team? Have you identified leaders who “own” each of the following aspects of the business: operations, marketing, support services? Do these individuals contribute to setting annual goals for the company? Do their department results contribute to creating a healthy and profitable organization? If you answered no to any of these questions, you may need to review your organizational structure or create one that empowers team members and creates clear expectations.


Clinics with a successful leadership culture have a well-defined vision and values. A clear vision and value statement set the stage for where you are headed and how you expect the team to behave and treat one another. Taking time to review your vision and values on an annual basis is a great second step to creating team alignment. A good vision should be personalized and may look something like this: “Axis Sports Medicine is the provider of choice for therapists and patients within the communities we serve.” Values may include a variety of items such as: customer service, leadership, clinical excellence, and empowered staff. Are your visions and values understood and embraced by staff? If not, engage your leadership team in defining, redefining, and promoting these statements.


Once you have reviewed your company vision and values, it is time to establish your annual strategic plan. Directing everyone down the same path has significant value in helping you achieve your business goals. The best place to define annual business goals is during the strategic planning process.

If you have never developed a strategic plan, you may want to seek outside help from someone who can walk your team through the process. Consider setting annual goals in four to five key aspects of your business: staff engagement, company growth, profitability, customer service, and leadership development are examples. Each goal should be owned by a member of your leadership team. Those individuals can then engage staff to own small goals and action plans that will lead to achievement of the strategic goal. At the end of the strategic planning process, each goal should have specific plans for implementation and should be fully developed with short-term action steps.

directing everyone

One of the most common mistakes in strategic planning is not aligning individual goals with overarching company goals. When staff goals don’t align with company goals, there is often little follow through. Goals are discussed when developed but never revisited until the annual review process occurs next year. This cycle can result in staff who are not engaged in creating meaningful progress and change. Individual goals should be specifically aligned to the strategic plan and have defined metrics for measuring progress.

Annual goals specific to leadership development may vary from establishing an effective organizational structure to department leaders achieving results through their team. Like patient care, goals should be objective and SMART (specific, measurable, attainable, realistic, time-bound).

Develop a process for routine evaluation and discussion of progress toward individual and strategic goals. This may be done through a monthly business meeting or individual weekly coaching sessions. Regardless of the process or timing, consistency of follow-up is essential to success. It is very true that what is measured is what gets done. Put these follow-up meetings on the schedule and stick to it.


What qualities and skills need to be developed for the leadership team in your company? Many times, the person with the best clinical skills gets promoted to a leadership role. Sometimes those people aren’t the best suited for leadership. Define the qualities and skills that are needed for each role, and hire and train specifically for those qualities and skills. Goal setting, team building, communication, metric management, time management, and execution (getting things done) are essential traits that all leaders need to develop.1 Which of these would have the greatest impact with regard to the leadership team achieving greater results within your company?

To develop a sustainable leadership culture, all leaders need to be coached and mentored. This includes the owner. The owner may need coaching from an outside source so that he or she can effectively mentor the leaders within the company. If you develop a “coaching culture” in your business, coaching will occur vertically and horizontally. This will lead to a culture of lifelong learning with people actively seeking to learn and receive feedback from others within the organization. If you plan to grow as a business, it is never too early to develop the next generation of leaders.

Leaders accomplish results through others. If you feel the need to do everything yourself, then you most likely haven’t developed a leadership culture. Daniel Pink, in his book Drive, writes that “Autonomy, mastery and purpose are what motivates others, not monetary reward.”2 How do you tap into these motivational drivers? Have you provided clear expectations to your company leaders and given them adequate support and autonomy so they do not feel micromanaged?


Consistency and long-term commitment are keys to developing a leadership culture that will move the business forward. Many times, owners/leaders energetically pursue the development of the strategic plan and business goals, but they fail to put into place a plan that routinely evaluates progress toward those goals.

As you work with your leaders, are you telling them what to do or asking them what they think they should do? There is a huge difference. Asking questions is one of the most powerful mechanisms of getting your leaders engaged and thinking about next steps. During your weekly coaching sessions, you may want to have a few questions that you always ask: (1) What was your biggest accomplishment this week?, (2) What did you want to accomplish that you didn’t and why?, and (3) What did you learn and what would you do differently?


Creating a leadership culture is an ongoing process that doesn’t end. Periodic reevaluation is critical to ensure that you are on the right path. Start from the beginning and ask those same questions. The vision and values of the company should be visible in your staff’s actions daily; if they aren’t, they should be revisited. The strategic plan should be a living plan that is evaluated and measured frequently at both the business and individual levels. A strategic plan that doesn’t drive action is just a meaningless piece of paper.


1 Rath T, Conchie B. Strengths Based Leadership: Great Leaders, Teams, and Why People Follow. New York: Gallup Press; 2008.

2 Pink D. Drive: The Surprising Truth About What Motivates Us. New York: Riverhead Books; 2009.

3 ouzes J, Posner B. The Leadership Challenge: How To Make Extraordinary Things Happen in Organizations. 5th ed. San Francisco, CA: The Leadership Challenge; 2012.

For Further Reading

Passmore, W. Developing a leadership strategy: a critical ingredient for organization success. A White Paper. Accessed Nov. 22, 2017.

Robbie B. Leonard , PT, DPT, is a PPS member and practice consultant with 8,150 advisors. She has more than 25 years of practice administration experience with expertise in revenue cycle management, corporate and practice compliance, and charge capture. Robbie can be reached at

*The author has a vested interest in this subject.

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

Are you a PPS Member?
Please sign in to access site.
Enter Site!