Taking care of business, taking care of hearts- Balancing leadership styles

Hayley Boling, MBA

“Effective leaders need to be flexible, and must adapt themselves according to the situation.”

-Ken Blanchard & Paul Hersey

As a new administrator, there are going to be several things that you’ll want to address early in your tenure. You’ll likely find inefficiencies— both operationally and financially—that will require your attention. You’ll probably find HR issues that resemble an onion, several layers deep and stinky, that will demand action. You might even see glaring discrepancies in skillsets, workloads, wages, and methods of accountability for your staff that necessitate a carefully constructed strategy. 


Your to-do list will seem long and daunting—each time you cross one thing off, you’ll add three more. At times, you’ll feel overwhelmed and underappreciated, and there will be moments that you feel like giving  up. Fortunately, your new leadership role also has the amazing potential to positively impact thousands—practice owners, employees, patients, and the community you serve—when you pre- pare yourself to be agile and balanced in your leadership approach. To fully real- ize this potential, your biggest challenge as a new ophthalmic administrator is to find that balance and learn how to take care of business while taking care of hearts.




As you’ve already learned by now, a practice’s culture is far from static. It is subject to change—for better or worse—which is why your leadership style must remain flexible and poised to address the needs of your team.

Upon stepping into my role, I quick- ly learned that in addition to challenges of inefficiencies, HR issues, and skills deficiencies, the practice had experi- enced extremes in leadership styles.  One practice manager who’d been with the practice for nearly 20 years was

all about relationships. Her primary concern was ensuring the staff appeared happy. As a result, there was little accountability as well as inconsistent application of rules and policies. As you can imagine, this created a culture of perceived favoritism as well as a lack of efficiency and overall productivity.

Although there are several advantages to the administrator’s relationship lead- ership style—employees typically feel appreciated and valued, and they be- lieve their contributions make a positive difference for the organization—there are also several disadvantages to consid- er: employees might feel overwhelmed by their job responsibilities due to a perceived lack of direction.  Ambiguous job requirements, ineffective decisions, and misaligned priorities can result,  due to disproportionate emphasis on employees’ feelings and relationships.

The practice administrator who fol- lowed in those footsteps was the polar opposite. Coming from a manufactur- ing background, he was solely focused on efficiency and productivity. In his mind, every task and every outcome could be mapped and predicted by a spreadsheet. He did not seem con- cerned with the “warm fuzzies” or the soft skills in management. As a result, the staff felt underappreciated and overworked, much like assembly line workers in a factory. They longed for the opportunity to connect on a deeper level with the practice and its patients.

This practice administrator was clearly a task-oriented leader, which also comes with its pros and cons. Task-ori- ented leaders set very clear practice goals and job requirements, allowing  for timely completion of job duties. These leaders are able to maintain high work standards while maximizing effi- ciency and productivity. Unfortunately, as I observed in my practice, they can also create low morale and a lack of  staff engagement.

Since both leaders allowed their natural tendencies to shape their leader- ship styles, neither ended up providing the responsiveness that is necessary to thrive as a successful leader in today’s dynamic practice setting.



Finding a Balance

During the first 6 months of my tenure, I found it essential to spend quality time in each department to learn about the personalities and skill sets of each team member. I asked questions, observed people in action, and took lots of notes. I tried my best to refrain from making suggestions, so that the staff knew that I truly wanted to learn how they handled their important portion  of the overall patient experience. Once  I was able to put my arms around a de- partment, I moved on until I saw each and every task performed by each and every person expected to perform them.


This “practice tour” allowed me the opportunity to truly assess the needs of the team. It taught me about the good, bad, and ugly of the past and present, and by taking the time to listen and observe, I was able to vicariously learn through my predecessors. It became obvious to me that a one-size-fits-all leadership style was not what my team wanted or needed.


This was one of several “aha” mo- ments for me in my new role. I realized that my leadership style couldn’t be too far in either direction—relationship or task—and that my leadership style should cultivate a combination of the previous leaders’ styles, while encour- aging flexibility to lean one way or the other based on the needs of each individual and situation I encountered. By identifying my own unique blend of these styles, I was then able to facilitate the creation of a practice culture where tasks are completed efficiently and effectively while positive working rela- tionships are fostered and nurtured.

Admittedly, identifying the right time to be task-centered versus relationship-centered has been the most chal- lenging part of this journey for me. After considerable research, practice, and time, I have learned that finding the right blend is certainly more of an art than a science, and every leader’s approach will be unique to the team s/he is serving.


Early on in my tenure, particular- ly when I was earning the trust and building positive relationships with the staff, I primarily applied a relation- ship-oriented approach. At that point in my career, it was more important for me to build long-term trust and buy-in. Now that I have cultivated positive relationships with the members of my team and continue to nurture them on a consistent basis, I now am able to take more of a task-oriented approach in my daily leadership duties.




  • In our highly regulated industry, it would be easy to want to jump directly into a task-oriented style; however, don’t forget that your practice culture and employee satisfaction are major parts of your practice’s overall strategy for success. Even when the relation- ships and trust have been formed, it is still critical for you to remain flexible and balanced in order to adapt your style to the needs of your team at any given moment.

  • Be sure to remember that a leader who creates a blended leadership style will have a higher likelihood of being the leader your team both wants and needs to be efficient and effective. By setting goals, identifying tasks, and creating timelines, you will ensure your team stays on schedule and remains clear about their roles within the practice. By cultivating positive relationships and trust, you will be able to motivate and inspire your team while creating a culture where every member feels valued and appreciated.

  • Once you have found the balance that is right for you and your team, you will be able to successfully take care of business while taking care of hearts. And that, my friends, is something you can cross off that to-do list

LASOA is a division of the Latin American Society of Cataract and Refractive Surgeons (ALACCSA-R)

© 2017 LASOA • 2446 W Whittier Blvd, Montebello, CA  90640-3041, USA

TEL. 323 887 8888