Discover how private practices can avoid costly promotion mistakes and build management teams focused on mentorship, accountability, and growth.
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Episode 62
A 2023 DDI study found that 50% of employees in private practices cite poor management as the top reason for leaving -- costing practices an average of $10,000 per employee in turnover. As Peter Drucker said: management is doing things right; leadership is doing the right things. In most private practices, neither is happening -- because the wrong people are in management roles.
Brandon makes the case through a simple analogy. Ralph is your best salesperson -- selling double anyone else, month after month. So you promote Ralph to sales director. Now you have lost your best performer, hired an untested manager, and created resentment in the team he is supposed to lead. The assumption -- that what made Ralph great individually will transfer to the people around him -- almost never holds. In clinical healthcare, this plays out constantly: the best therapist gets promoted to clinical director because of patient outcomes, not because of any demonstrated ability to coach, hold people accountable, or navigate interpersonal conflict. Talent in a role and talent at managing that role are completely different skill sets.
Brandon uses an analogy: loving management is like loving horror films. It is polarizing. The people who thrive as managers are the ones who enjoy the discomfort -- resolving team conflict, delivering hard feedback, sitting with uncertainty about an underperforming employee. They are energized by the pressure. They see conflict as a challenge to navigate, not a threat to avoid. The ideal manager is like a personal trainer who knows how to deliver tough love that produces results while keeping the client fully bought in. Not someone who feeds marshmallows during push-ups -- someone who gets you to the goal because they genuinely want you there.
Stop promoting talent into management. Start recruiting managers the same way you recruit clinicians -- with a specific candidate profile and a deliberate selection process. In interviews, ask why they want to manage, not what they have managed. Look for answers that center mentorship, team growth, and problem-solving -- not salary or title. Use behavioral interview questions and role-play scenarios to surface emotional intelligence. Require 12 months of demonstrated leadership capacity before granting the formal role. Write your job posting with full transparency about how hard management actually is -- because the thrill-seekers you want are not deterred by difficulty. They are drawn to it.
