One of the biggest complaints I hear from practice owners is:
“Why can’t my staff just take more ownership?”
They’re tired of answering the same questions.
They’re tired of checking whether things got done.
They’re tired of being pulled out of a treatment room because someone needs a decision that should have been handled without them.
Eventually, the doctor starts thinking:
Maybe I need better people.
Sometimes you do.
But before you start replacing employees, there’s another question you need to ask:
Have you actually trained your team to take ownership?
There is a big difference between showing someone what tasks to perform and training someone to understand the purpose of their position.
And that difference can determine whether you build a team that constantly needs you or a team that helps your practice run without you.
Medical Practice Staff Training Is More Than a Checklist
A lot of practice owners don't really train people.
They hire someone, show them their desk, give them a list of responsibilities and expect them to figure everything else out.
Answer the phones.
Schedule patients.
Collect payments.
Prepare the treatment rooms.
Follow up with patients.
Those things certainly need to be taught.
But a checklist tells an employee what to do.
It doesn't necessarily teach them why they're doing it.
That is why I believe in what I call purpose-driven training.
Every person in your medical practice should understand the purpose of their position and the results they're responsible for producing.
Don't Assume Experience Means They're Trained
This becomes especially important when you hire someone with experience.
Maybe your new employee spent ten years working for another doctor.
Great.
They probably bring valuable knowledge with them.
But they were trained inside somebody else's practice.
Their previous employer may have answered the phone differently, scheduled differently, communicated with patients differently or handled problems differently.
You can't simply assume:
“They've done this before, so they already know how we do it.”
They don't.
When I hired experienced people into my own practice, I wanted them to first learn our systems and our expectations.
Once they understood how we operated, I absolutely wanted their ideas.
Maybe they had a better way of doing something.
Maybe their experience could improve one of our systems.
I'm open to that.
But first, they needed to understand the system they were trying to improve.
Otherwise, one new employee can unintentionally create confusion for an entire team.
Give Every Employee a Clear Purpose
Ask one of your employees:
“What is the main purpose of your job?”
You may be surprised by the answer.
A front-desk employee might say:
“My job is answering the phone.”
That's a task.
It's not the purpose.
For example, the front desk has a much larger responsibility in the performance of a medical practice. They influence whether the appointment book stays productive, whether patients actually keep their appointments, how patients experience the practice, and whether money owed at the time of service is collected.
Peter has made this distinction in his existing teaching as well: owners need to educate staff on their purposes and priorities rather than assuming employees already understand them.
When employees understand the result they're responsible for, they can begin making better decisions without asking you about every little detail.
That's where ownership starts.
Set Expectations Before You Hold People Accountable
You cannot expect an employee to read your mind.
Yet practice owners do this all the time.
They know exactly how they want something handled, but they've never clearly communicated it.
Then someone does it differently and the owner gets frustrated.
That's backwards.
Tell people what you expect.
Show them how your practice operates.
Explain why it matters.
Give them the tools and training to succeed.
Then hold them accountable for the result.
Clear expectations have to come before accountability.
Train First. Then Empower.
This is where many doctors get stuck.
They either micromanage everything...
Or they delegate something and disappear.
Neither is leadership.
The better progression is:
Train → Observe → Correct → Retrain → Empower → Follow Up
Peter’s earlier writing makes essentially the same point about delegation: staff should be trained and empowered, but delegation still requires follow-up rather than simply handing someone a task and forgetting about it.
As the employee becomes competent, you should need to intervene less.
That's the goal.
You don't want employees who need permission for every decision.
You want people who understand the systems, know what results they're responsible for and can handle their responsibilities confidently.
Your Team Should Make Your Practice Less Dependent on You
The goal of medical practice staff training isn't simply to create better employees.
It's to create a better practice.
If every question still comes to you...
If every problem requires your approval...
If you're constantly checking whether everyone did their job...
Then you're not really leading a team.
You've created a group of people who still depend on you to operate.
A well-trained team should give you leverage.
It should allow you to spend more time treating patients, developing your practice, thinking strategically and eventually stepping away without wondering whether everything will fall apart.
That philosophy is central to Peter's broader approach: strong systems, mindset and leadership are what allow practice owners to reduce chaos and create a profitable practice that doesn't consume their lives.
Before You Blame the Employee
The next time an employee isn't performing the way you expected, don't immediately assume you hired the wrong person.
Ask yourself:
Did I clearly define their role?
Do they understand the purpose of that role?
Did we properly train them in our systems?
Do they know exactly what I expect?
Have I followed up and held them accountable?
Sometimes you do have the wrong employee.
But sometimes you have a good employee who was never given the structure necessary to become great.
And as the owner, recognizing the difference is part of your job.
Because the goal isn't to build a practice full of people waiting for your next instruction.
The goal is to build a team capable of moving the practice forward without you having to push every step of the way.
— Dr. Peter Wishnie