Is “leadership” the most overblown, incessantly talked about topic on the face of the planet?
If you’re ever wanting to find a good book on leadership, my advice is not to go on Amazon and type the word in to the search bar because it’ll only return…”over 70,000 entries” in less than one second.
Haven’t we all had enough of people writing about “mindsets,” “hacks,” “philosophies,” “quick fixes” and “lessons from…”?!
To be clear, all of this has a place and I probably read about as many “self-help books” as you do, but there comes a point in business where we get paid to deliver. We get paid to take action. We get paid to drive results through our team. I believe in optimism as much as the next guy, but clarity pays the bills.
Don’t let your mindset get in the way of your execution.
And don’t get too absorbed in strategy when tactics are called for.
If you’re scared of getting your hands dirty, cut your fingernails.
Now is that time, which is why I planted the flag in Los Angeles a few weeks ago for my Executive group to assemble and learn how to be better CEOs.
IBM was once THE leading American tech company with its pioneering efforts in personal computers, mainframes, and the DOS language that ran all of it. The company became an uncoordinated and tangled mess in the late 1980s until they hired a guy named Lou Gerstner away from RJR Nabisco to run it in 1993. After he had only been there a short time, the press asked him about his vision for the company, to which he replied: “the last thing IBM needs right now is a vision.”
Shocking in its brevity. Remarkable in its clarity. We should all be so inclined.
Gerstner focused on execution, decisiveness, simplifying the organization for speed, and breaking the gridlock between units and departments. If you’re wondering what you can do to be a better CEO of your own business, stop reading right now and focus on those four things.
If you’re wondering what we spent the better part of two days doing together in Los Angeles, here are a few highlights…
The Face in the Mirror
In the early stages of your career, you gain a title of leader – sometimes through promotion; sometimes by buying the actual business. At this stage, some incorrectly assume that their self-confidence can overcome any situation or mistake they make. It can’t…
And others incorrectly assume that the people they employ view them as a fraud. They don’t…
A good economic downturn will humble the former group, so I’ll focus more on the latter. It’s worth noting that 100% of the people who are in my Next Level Executive group operate with a level of collective humility that is frankly remarkable given their individual levels of accomplishment. The two other characteristics I would use to describe them as a group are: authentic; and a penchant for action. Let that be “Step One” in your leadership development education…
Those who are both authentic and humble tend to suffer from something called “Imposter Syndrome.” I often state that suffering from imposter syndrome in some ways means “you’re doing it right.” We all have doubts about ourselves. We all suffer from insecurities. We all worry that if we lead, no one will follow.
In a world of clinical education, board exams and licensure, there’s ample acknowledgement of your worthiness and ability to perform your clinical craft.
But what about your role as leader, executive or CEO? Where’s the certification? The diploma? The license? Without any of those, have you really earned the right to call yourself a leader?
You can easily be promoted into management, but leadership is bestowed upon you by your people, and it’s earned through your experiences. For all of the many leadership roles I’ve held through multiple decades, I can think of only one where I was truly prepared – and that one didn’t go as planned, either.
If you want to be an authentic leader, then accept the fact that you’re never truly prepared. And when you do figure out what you’re doing, the business grows in complexity which ultimately means you have to figure it out all over again.
The bottom line is the following: you’re worthy and have earned the right to be in the role. Whether you believe that to be true or not…either way…you’re correct.
Embracing Uncertainty
I’ve been talking incessantly in our group about my outlook for the coming years, and it’s not filled with abundance or optimism. I’ve also alluded to some of this in the podcast and in prior essays. I think we’re already in the beginning stages of a period of uncertainty or possibly even an economic downturn. “Cycles” are known as cycles for a reason. There’s a rise and a fall. The fall is the economic phase where many sub-standard businesses fail. It’s “the culling of the weak from the herd.” It’s natural. And it’s often needed.
For those of you who entered in the workforce after 2010, you’ve only experienced economic expansion (with the exception of a quick recession post-COVID, but the Federal Government “shared” a trillion dollars to ensure it was short-lived). If you’ve never lived through an economic downturn, then my gut is telling me that you’re going to get an up close and personal look at one very soon.
Here’s something I’ve learned in my decades leading businesses: it’s really hard to be an effective leader during times of economic expansion.
When a rising tide is lifting all boats, organic growth will usually wipe away the gap that results from a bad decision, so we’re deluded into thinking that our decisions don’t have consequences. Even worse, there’s no internal or external pressure on our teams, so it’s all but impossible to instill in them any sense of urgency. And if we push them too hard, then there’s always someone else waiting and willing to hire them at a higher wage rate than we can offer.
When everything is “all good,” we tend to coast. Worse yet, we start to believe that the growth and performance of our business is a result of things we have done when it’s really more of the market giving us a lift.
In times of abundance, we lose our objectivity.
Here’s the corollary: true leaders look forward to times of trial because they know they can make a difference. Time of trial create urgency – and sometimes fear. Times of trial force people to recommit. Times of trial necessitate change for survival.
And times of trial make people listen more acutely to people in leadership roles. That’s each and every one of you reading this. Are you prepared for your opportunity?
We’re entering a period of uncertainty, and uncertainty necessitates change. The late Jack Welch, former Chairman and CEO of General Electric, frequently stated: “When the rate of change outside an organization exceeds the rate of change inside it, the end is near.”
Uncertainty is coming. Change is needed. Are you ready to lead through it?
Getting Tactical
If there is no more “rising tide” to lift your boat, that probably means that “big wins” and “exponential growth” are no longer possible. If you get it, great – take it. Should you plan on it? Absolutely not.
Survival, let alone winning, in this next phase of the economic cycle comes down to capturing small wins. In baseball, it’s called “manufacturing runs.” In business school (and professional cycling!), it’s referred to as “the aggregation of marginal gains.” In this theory, your 10% growth probably won’t come from one or two sources that each yield 5% revenue growth; it’ll more likely come from 8 to 10 different areas that each yield around 1% improvement. It’s those 8 to 10 areas that add up to the 10% you seek.
Applying focus and figuring out where you can improve means thinking creatively about everything in your business. It means taking apart the entire equation to figure out where you can be better. In Los Angeles, I took the group through a deep dive into strategic planning and used Patterson’s fiscal year as a concept to show how everything must be a possibly when it comes to improvement.
In the world of aggregating marginal gains, everything matters. We dug deep into actually using the annual cycles of patient flows, mental energy, and physical stamina to your advantage. I showed how Patterson built a business that captured 50% of the capital equipment and technology sales volume even though they only had about a third of total market share. Pure genius when you allow yourself to think differently and creatively.
If your goal is to grow 10% this year, do you know where it’s really going to come from? Many of you are good at thinking you’re a “strategist.” In the coming cycle, it’s the tacticians and the operators who can execute that are going to excel.
It’s time for many of you to rethink your Strategic Planning Process for 2026.
Communication Skills & Frameworks
The reason so many people underperform or fail at the craft of leadership is because, simply put, they cannot build a following. “Building a following” means reaching your people at a deeper level that creates commitment and a belief in their ability to compete and win in today’s marketplace.
General Dwight D. Eisenhower has a great quote: “leadership is getting someone to do something because they want to do it.” He knew a thing or two about leadership.
Your biggest asset as an executive is your ability to communicate – and in times of trial, it’s of paramount importance to communicate constantly. Create urgency. Reinforce behavioral change. Celebrate wins. Paint the picture of where you’re going and how you’re going to get there.
Here’s one critical point to remember: your people want to be led. And they want you to lead them.
“Leading them” means being out front. It means owning the message. It means instilling hope. Effective executives communicate constantly in a variety of media and in a variety of settings. For example:
- An annual company-wide presentation on goals and outlook for the new year
- A quarterly departmental meeting with your doctors on working together to share best practices on your treatment conversion rates
- A weekly voice memo to someone on your team who created an incredible result
- A monthly written memo on the year-to-date performance of the practice
- A written note card congratulating an employee on a recent achievement
- A personal video to a practice for their morning huddle and the importance of finishing the month strong
Becoming a better communicator means using a variety of media in a variety of applications for a variety of groups through a variety of delivery methods. Becoming a better communicator means doing it constantly. Becoming a better communicator means being both the drumbeat and the heartbeat of your business.
To be an effective executive means that you have to build a Framework for a meeting cadence to fall back on. The framework should break down all of the different groups (company, department, practice, etc.) along with the frequency of each (annual, quarterly, monthly, weekly, etc.) as well as the potential subject matter involved.
Do you have a system or repeatable process that facilitates your communication to the groups in your company?
If you do, do you know what you want to say? And do you know the intended effect you hope to create?
Driving Results through People
I frequently remark that being an Effective Executive means “creating greater results through the work of your people in less time than you could do so on your own.” The military refers to this as being “a force multiplier.” Being an executive itself simply means that you’re creating results through others.
Sounds simple. It isn’t.
There’s an old adage that “you manage things, but you lead people.” For the most part, that’s true. Your role and mine (from a prior life) is, however, a blend of both. Most of you are equal parts “Departmental Manager” as you are “Business Unit Leader.” And on any given day, my bet is that you wear both hats, depending on who or what you’re dealing with.
I abhor the adage “your people are your biggest asset.” In most companies, they aren’t. They simply show up to do a job where the manager, leader or owner treats them like cattle. You don’t live in a world where “cattle” create a great patient experience. Cattle don’t create extraordinary results. Your team can be your biggest asst, but it’s up to you to develop them and get the most out of them. That’s leadership. And if they’re not the right fit or don’t want to go along with what you want, then you need to upgrade. That’s being in the “talent management” business. That’s leadership.
I took the time in Los Angeles to break down some basics that fall into the “management bucket” and others that fall into the “leadership bucket” to illustrate the distinction between the two.
Let me share a key takeaway: if I’m accurate in my prognostication around a period of economic uncertainty, you won’t be able to manage your way through it; you’re going to have to lead your team and your patients to better outcomes.
You’re going to have to create the security you seek.
Playing to Win
So why are there over 70,000 books on leadership in the Amazon catalogue? Because we’re Americans. I’m actually serious.
Before we were a country, we were settled by people filled with a spirit of exploration or those wanting to create a better life than what they had from where they left. As the country fought its way into becoming colonies which became states which started a revolution and then formed a unifying government, the spirit of freedom and the opportunity to control our own destiny became central to the American ethos.
America is entrepreneurial to its core. In that same spirit, we all seek guidance on self-help and continuous improvement. Judging from the results on Amazon, there’s a lot of it out there.
In my nearly three decades of being in leadership roles, I believe that leadership is probably more art than it is science. Regardless of the proportions, it’s pure craft – and you can improve at it. But only if you want to. Improvement is an active process – not a passive one.
One of the books somewhere on the Amazon list of 70,000 plus titles is by a Harvard Business School professor named John Kotter, called “Leading Change.” Leading change is what you’re all in the midst of – even if some of you don’t realize it. Go back and re-read the Jack Welch quote in the “Embracing Uncertainty” paragraph if you’ve already forgotten it.
Kotter’s book is an objective, process-driven approach to the topic. It’s a good read that is especially relevant in these times of uncertainty. In the conclusion, he gives his outlook on “the 21st Century Executive” based on a study of a handful of HBS graduating classes from the 1970s. Specifically, they followed these groups and after several decades tried to determine what made those successful over those that were less so. The findings were quite specific: one, they made a commitment to lifelong learning, which led to, two, an ever-increasing competitive capacity.
There are a lot of people who read a lot of books. I’ve asked the question before of, “how many do you actually study?” And secondarily, “of those you study, how many do you actually apply?” Lifelong learning isn’t simply a reading practice. It’s study. It’s application. It’s discussion and questioning. It’s learning from those who have already trod the path. And it’s obviously critically important to developing and refining a greater capacity to compete and to win.
My writing and my podcast attract a lot of thoughtful people who want to learn and be educated. I love that and I love my discussions with each of you. But education isn’t the answer. Not anymore. Not now. It has to be application. It needs to be execution.
“Leading Change” has to start with you. And it probably should’ve started in early 2025. Are you prepared to increase your competitive capacity as we approach 2026? If the answer is “no,” then the rising tide is no longer rising. It’s going out. If your answer is “yes,” then step to the fore in front of your people to tell them where you’re going and what you expect out of each of them.
“Leadership is getting someone to do something because they want to do it.”
Now go grind some beans.
