Beyond the Triangle: Rethinking Leadership in Healthcare Business
How Do You Visualize Your Leadership Structure?
Leadership
March 5, 2025
If you had to sketch the structure of your business or team, what shape would it take?
🔺 A triangle, with leadership at the top and decisions flowing downward?
⭕ A circle, where every team member has an equal voice?
⚙️ A wheel with spokes, where leadership connects different departments and keeps things moving?
For physician-entrepreneurs, leadership isn’t as straightforward as it is in traditional medical settings. Many start off as both the leader and the operator—managing the business while still seeing patients. But as their business grows, the leadership model must evolve.
- A solo practice expands into a multi-location business—who takes the lead?
- A consulting firm adds partners—how do you divide decision-making?
- A healthtech startup scales—when do you step back from daily operations?
The leadership challenges in healthcare entrepreneurship, private practice growth, and consulting require a different mindset than clinical medicine. In The Hard Thing About Hard Things, Ben Horowitz reminds us that leading in uncertainty isn’t about finding the perfect model—it’s about navigating chaos, making tough decisions, and empowering teams.
Rethinking Leadership in Healthcare Business: 3 Lessons from The Hard Thing About Hard Things
1. Leadership Isn’t About Finding the Perfect Structure—It’s About Adapting
Many physician-entrepreneurs believe there’s a right way to structure their business—whether it's a traditional hierarchy, a flat organization, or a partnership model. But no structure is perfect, and sticking too rigidly to one can hold you back.
Horowitz warns against falling for abstract leadership theories and instead advises leaders to adjust their leadership style based on the situation.
🏥 Example:
A multi-location private practice might start as a triangle, with the owner at the top making key decisions. But as new locations open, that structure can create bottlenecks. Shifting to a wheel model, where each location has an independent manager but stays connected through centralized leadership, allows for better decision-making and scalability.
🔥 Is It Time to Change Your Leadership Model?
Ask yourself:
✔️ Are you still making all major decisions, even small ones?
✔️ Are team members hesitant to take ownership?
✔️ Do you find yourself being the bottleneck in daily operations?
✔️ Is your growth limited by your personal bandwidth?
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If you answered yes to two or more, it might be time to rethink your leadership structure and delegate more authority.
2. The Hardest Decisions in Leadership Are the Uncomfortable Ones
Horowitz doesn’t sugarcoat leadership—he highlights the loneliness of making hard calls. In healthcare business leadership, these hard decisions include:
- When to pivot or shut down an idea.
- When to hire or fire key team members.
- When to invest in growth vs. stay lean.
For many physician-entrepreneurs, letting go of control feels deeply personal. Your business isn’t just a business—it’s your reputation, your vision, your name on the door. Making changes can feel like losing a part of yourself. But great leaders recognize that holding on too tightly can actually limit growth.
🏥 Example:
A practice owner may struggle with stepping back from day-to-day patient care to focus on scaling operations. It feels uncomfortable because patient care is their identity—but without shifting into a leadership role, the business will hit a ceiling. The hard decision is choosing long-term growth over short-term familiarity.
🔥 Action Step: Identify one tough business decision you’ve been avoiding. What’s the real reason for the hesitation—fear of pushback, uncertainty, or emotional attachment? Take one step toward resolving it this week.
3. Build a Team of Independent Thinkers, Not Just Followers
One of Horowitz’s biggest leadership lessons is that great teams don’t just follow orders—they think critically and solve problems.
In clinical medicine, hierarchy often discourages independent thinking. Physicians give orders, and the team executes. But in healthcare business leadership, this approach can slow down innovation and decision-making.
🏥 Example:
A physician-led specialty practice may start with a top-down approach, where the founder makes all major decisions—from hiring to service expansion. But as the practice grows, relying on one person for every decision creates bottlenecks. By empowering clinical directors and administrators to own key areas like operations, marketing, and patient experience, the practice can scale more efficiently while maintaining high-quality care.
🔥 Action Step: In your next leadership meeting, delegate a strategic decision to a trusted team member and encourage them to take ownership of the outcome.
Leadership in Healthcare Business: A Living System
Leadership in healthcare entrepreneurship, consulting, and private practice isn’t static—it’s a constantly evolving system.
As Horowitz reminds us, leadership isn’t about having all the answers—it’s about navigating uncertainty, making tough calls, and empowering teams to solve problems.
At Lucens, we know physician-entrepreneurs don’t always have a roadmap for leadership beyond medicine. That’s why we provide case studies, expert-led discussions, and mentorship opportunities to help you make smarter business decisions and scale with confidence.
👉 Explore how other entrepreneurial physicians are navigating leadership challenges—join the Lucens community today.
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