Hope is not a strategy!

Tina Soika (not pictured) has had a distinguished career in management, the last 6 years as president of American Hearing Aid Associates, West Chester, Pa. Marty Layne, AuD, has been in private practice audiology for more than 25 years and is CEO of Marty Layne Associates, Scarborough, Me.

Some people are born to manage a private practice business; however, most of us have to learn the hard way. Marty Layne, a successful private-practice audiologist, is one of the latter. She and Tina Soika draw on their experiences to discuss five habits cultivated and developed during their many years of leading thriving businesses.

A practice cannot progress unless you, the owner (and CEO, if you will), drive it. And to drive it successfully, you must make a commitment to become its leader.

Successful leaders manage change effectively, develop and implement a plan for the practice, invest in the practice, and make a conscious decision to spend their time productively with high energy and high focus. This article looks at these five essential traits for successful private practice management.

1) Become a True Leader Through Hard Work and Self-improvement

Some leaders are born. But for most of us, leadership traits and skills can be learned and developed. The fact that you are the owner of a practice is a strong indication that you have the basic qualities of leadership. It remains for you to nurture and grow those qualities through education, observation, and peer sharing.

Marty Layne did just that. She started in audiology in 1984. Eleven years later when she opened her own practice in 1995, she made a commitment to becoming a true leader. To this end, she joined American Hearing Aid Associates and began taking advantage of its many educational services and peer-sharing opportunities to hone her leadership skills. Additionally, she used other outside resources, such as reading business books and periodicals.

She developed and stuck to a strategic plan for her practice, and today—some 14 years later—she has expanded her practice to three locations, hired more professional staff, and is serving increasing numbers of patients with highly profitable financial results. Marty’s transformation was no accident. Her efforts to become a true leader of her practice are attributed to the remaining four key behaviors.

2) Manage Change with Vision

Early on, Marty began to realize that, yes, the marketplace was producing changes that had to be addressed. More importantly, she saw that her staff had to be motivated to change too. And change had to start with her as the leader. She had to create a vision for her practice, and then she had to learn to effectively communicate that picture of the future with high hope and urgency.

Your vision for change can comprise many things, including the state of the industry and how you and your staff can best capture your share of business, expanding the number of offices and personnel, and details of a serious marketing plan.

As CEO, you may have been successful thus far. But understand that a vision without change will not get your practice to the next level. You should identify what needs to change in your practice and then lead your staff to successfully effect those changes. The first thing most leaders need to reckon with is that the person who most needs to change in the practice is the CEO!

Your job is not to make the inevitable happen. Your job is to move the practice forward in innovative, even surprising, ways. Your job is to make the difficult happen and to motivate your staff to participate in the effort. That’s what leaders do.

The critical first step is to identify what and who needs to change and why, and to explain how change will benefit them. Keep it simple, and deliver your message for change in a few, clearly articulated points. Drive these points home to the staff with repetition, often in regular, face-to-face meetings.

Your staff must buy into how their jobs and responsibilities are important elements that lead to the success of the practice—and their success in it—and how they complement your work as CEO. It is critical to impress upon them that the CEO’s role is to drive revenue opportunities into the practice. Audiologists and dispensers drive quality patient care and customer service while achieving successful closure and binaural rates. The front office effectively manages inquiries and appointment management, and also provides impeccable customer service. Everyone has a role in contributing to the success of the practice. But all must act as a team, supporting one another, to achieve success.

Meet with your staff frequently, and whenever you meet with staff, make sure you effectively communicate your vision, their role in achieving that vision, and your explicit expectations for their successful performance of their jobs.

3) Develop and Implement a Plan for Your Practice

The key component driving vision and change, of course, is the strategic plan for your practice. As CEO, you must establish goals for where you want the practice to be in the near and far terms. You need to know how you will reach those goals, as well as what physical resources and personnel you will need to achieve them.

Serious planning represented a huge internal shift for Marty. It made her convert her daydreaming and wishing about the future of her practice into a definitive plan that put those aspirations in writing so that she could make them a reality. One of the aphorisms Marty learned is “Hope is not a strategy.”

4) Invest in Your Practice

Many CEOs reverse the concepts of investment and revenue. That is, it is not that they have to spend money and take risk to make more money. But rather, the imperative is much greater: “I have to invest more money in my practice or I will not grow.”

Investing in staff is a key to creating greater value in your practice. The success of your practice is directly tied to the quality of your staff, the number needed to allow you to expand and serve more patients, and their proper motivation to achieve success.

5) Manage Your Time Effectively: What Type of Manager Are You?

Many CEOs go to the office and then lapse into what can be called a high-activity coma. A high-activity coma is one in which there is much activity and a frenetic pace, but very little is accomplished in terms of moving the practice forward. The first step in becoming an effective time manager is to analyze how you spend your time now.

We can identify at least four kinds of time managers. What kind are you? Are you a purposeful manager, a procrastinator, disengaged, distracted? Let us review them in reverse order:

1) Distracted managers have low focus and high energy. Most managers fall into this group. They are shortsighted and overcommitted. They feel a desperate need to do something—anything—when pressure mounts. They are short on reflection, and they have trouble developing strategies and adjusting their behavior to new realities. They are exhausted at the end of every day but cannot point to significant strategic accomplishments.

2) Disengaged managers have high focus but low energy. They are usually exhausted and unable to commit to tasks that hold little meaning for them. They approach their work half-heartedly and deny any problems exist. They often refuse to act even when it is critical for them to do so.

3) Procrastinators have low focus and low energy. They dutifully perform routine tasks but fail to take initiative, raise performance levels, or engage with strategy. They are the giant-in-chains from Gulliver’s Travels or the Scarlet O’Hara-tomorrow-is-another-day managers.

These three managerial types are both ineffective and inefficient. They will not be able to lead their practices to higher levels. Their nonpatient care time is spent on marginal activities that don’t drive their practice forward.

4) Purposeful managers, on the other hand, have high focus and high energy. They define their goals and then control their environment to meet their objectives. They carefully orchestrate their time. They are crystal clear about their intentions, and they show unrelenting willpower. They pick their battles carefully and feel personally responsible for their practice’s future. They refuse to let others or organizational constraints limit their agendas.

To become a purposeful manager, then, make a conscious decision every minute of every day to spend your time productively and efficiently. Be clear about what you want to achieve. Make decisions to act and then act. Divide your day by allotting time for each of the following:

  • Growth and improvement of your practice;
  • Managing staff;
  • Primary day-to-day responsibilities; and
  • Administration.

When Marty changed her own way of managing her practice, she laid a solid foundation for success. The old Marty devoted most of her time (84%) to patient care, 1% to planning, 5% to managing staff, 5% to administration, and 5% to day-to-day responsibilities.

The change Marty implemented has her devoting 11% to patient care, 28% to planning, 22% to managing staff, 22% to administration, and 17% to day-to-day responsibilities.

One can see that she now has planning as a major activity, and that has allowed her to expand her staff so that she no longer spends so much time on patient care. She is a planner-manager-administrator, which perfectly positions her to move her practice to higher levels, keeping track of issues that might interfere with her goals, and motivating her staff to participate fully for their own benefit as well as that of the increasing number of patients they are serving.


We have presented a case study of an effective leader who began first with a commitment to be a leader, took steps to enhance her innate leadership skills with outside help, designed and made changes to her practice and her own management style, developed and implemented short- and long-range plans, invested in expansion and the staff needed for it, and rearranged the way she spent her time in her practice each day.

The result has been great success in terms of increased numbers of patients being treated with greater satisfaction, increased staff morale and motivation, and increased revenue.

Correspondence can be addressed to HR or Tina Soika at , or Marty Layne at .

Citation for this article:

Soika T, Layne M. The 5 essential habits of successful practice leaders. Hearing Review. 2009;16(10):18-19.