Running a medical practice is one of the most demanding leadership roles in business—and most doctors were never trained for it. You were trained to diagnose, treat, and deliver excellent care. But building a team, setting culture, managing performance, and getting consistent, high-quality work from employees? That’s a completely different skill set.
In this episode of Wealth Mavericks, the team speaks directly to practice owners who feel frustrated with staff—especially when complacency creeps in, attitudes shift to “that’s not my job,” and you find yourself doing more and more just to keep the day running. The conversation isn’t about blaming employees or defaulting to “fire everyone.” It’s about leadership, expectations, culture, and creating a high-performance team that serves patients well and supports the business you’re trying to build.
Start With the Mirror
The first place the team goes is simple—and not always comfortable: leadership starts with you.
Joe’s advice is direct: most doctors are great doctors, but they’re not yet great leaders. That’s not an insult. It’s a reality of the training pipeline. Unless you’ve intentionally pursued leadership development, you probably received little to no formal education on how to run a practice well.
When employees are underperforming, the first question isn’t “What’s wrong with them?” It’s “How well am I leading?” Because without a clear, compelling vision, people drift. And drift looks like complacency, misalignment, and poor initiative.
Vision Pulls People Forward
The episode emphasizes a foundational leadership principle: without vision, people don’t thrive. A practice can have talented employees and still underperform if there’s no clear direction pulling the team forward.
That’s why Terra Firma adapts tools like EOS (the Entrepreneurial Operating System) and frameworks like the VTO (Vision Traction Organizer). These aren’t just corporate buzzwords. They create shared language—mission, vision, priorities, and core values—so everyone understands what the practice exists to do and how they’re expected to show up.
For practice owners, this matters because culture doesn’t form accidentally. If you don’t define it, it will define itself.
Expectations Are the Root of Most Conflict
Megan makes a point every business owner needs to hear: conflict usually arises when expectations are unmet. And often, the expectations were never clearly stated in the first place.
That’s why the team stresses clear job descriptions, clear patient flow, and clear accountability. A practice should have a defined pathway—from reception to clinical staff to provider to checkout—so the patient experience is smooth, and the team knows how responsibilities transfer.
But here’s the nuance: even with clear roles, there will be overlap. And that’s where “that’s not my job” becomes dangerous. High-functioning practices require teamwork, not silos. If one person is drowning and another is idle, the system is broken—and the leader has to fix the system.
Core Values Aren’t Optional
One practical recommendation is to define core values—and hire against them.
Joe points out that many owners hire based on credentials alone. If someone checks the boxes, they’re in. That approach is catastrophically flawed when you’re building a team that must deliver a consistent patient experience. Skills can be trained. Values and character are much harder to build.
A simple example: if teamwork is a core value, then helping a colleague when you have capacity isn’t optional. It’s culture.
And if tenacity and grit matter in your practice, ask for proof of it during interviews. A great hire should be able to describe a time they persevered through something hard, not just list qualifications.
Learn From the Best: “Go Study Great Hiring”
Joe gives a memorable challenge: visit organizations known for great people—places like Trader Joe’s or Chick-fil-A. Watch how employees interact. Notice the tone, the service mindset, the consistency.
Then bring those observations back into your practice—not to copy competitors, but to upgrade your standard. Great leaders pay attention to moments, language, and experience everywhere they go, because those details shape culture.
Care About Your People—For Real
A major theme of the episode is that employees are not just functions in your business. They’re human beings with hopes, dreams, insecurities, and pressures—just like your patients.
If your staff doesn’t seem to care, ask an honest question: do you care about them?
Do you know what they like? What motivates them? What they’re working toward outside of work? If not, there’s no foundation for loyalty, ownership, or pride in performance.
The team shares examples of leaders who do small, meaningful things consistently—bringing lunch, recognizing effort, giving staff access to services the practice offers, and creating moments that communicate, “You matter here.”
Not as a performance. Not as a corporate “family” slogan. As leadership.
Stop Complaining and Make a Decision
One of the strongest takeaways is this: if you find yourself complaining about an employee repeatedly, you have two options—fix it or fire them.
Holding onto long-term underperformance creates an even bigger problem: it teaches the rest of your team that standards don’t matter. Tolerated dysfunction spreads. It becomes cancerous to culture.
And if you’re expecting ownership-level effort while paying entry-level compensation, that’s misalignment too. The team highlights a hard truth: you can’t pay people like they’re replaceable and then expect them to perform like they’re invested.
“Family” vs. High-Performance Team
A powerful section near the end reframes a common business cliché: your practice is not a family—it’s a team.
Teams care about each other, but they also operate with standards, accountability, and performance. A “kumbaya” culture without expectations collapses the first time the business hits tension.
The goal is a healthy middle: strong relationships, honest conversations, clear standards, and the ability to confront problems without walking on eggshells. Great teams grow through road bumps, not by avoiding them.
The Real Bottom Line
If you want better work from your employees, the path begins with leadership—not frustration.
Set vision. Clarify expectations. Hire intentionally. Build culture. Care about people. And make hard decisions when necessary. Because the practice will never rise above the standard the owner is willing to set and enforce.
👉 Watch the full episode here: