How to lead a clinic responsibly: a real-world lesson in healthcare leadership

Leading a clinic is not about control: it's about taking responsibility

A few years ago, while working as a veterinarian in a UK clinic, I met an exceptional nurse. Let's call her Brenda.

Brenda was brilliant. She started working as a nurse at the clinic and, at the same time, completed her studies thanks to a very common system in the UK: clinics fund the university education of healthcare staff in exchange for supervised work hours.

As she pursued her degree, Brenda took on more and more responsibilities. Eventually, along with the head nurse, she was in charge of training four student nurses. But that's where the real challenge began.

The problem: when the team doesn't respond

As often happens in large teams, Brenda began to notice that some nurses were not completing their tasks unless someone constantly supervised them. This not only affected the care of hospitalized patients but also added more pressure on Brenda and the rest of the qualified team.

They tried to accompany the students on every review, but the problem persisted. Frustrated, Brenda came to talk to me. She wasn't looking for me to solve the situation; she wanted to solve it herself. That, in itself, was already a sign of leadership.

Change begins by taking responsibility

I proposed something unexpected: gather the team and tell them that it was her fault.

She was surprised. She looked at me and said:
"You want me to tell them it's my fault, even though it's not?"

And I replied:
"Yes. Because it is. If you're in a supervisory position, everything your team does—or fails to do—is your responsibility. If they haven't done the right thing, it's because you haven't taught them well or haven't created the conditions for them to do it."

I added:
"And in fact, this situation is also my fault. Because I didn't see that you needed help leading the training of four students, in addition to your other tasks."

Empowering through responsibility

So we approached it this way: we would have a meeting. We would first explain why it was important for patients to receive timely reviews. Then we would admit that they were not being done correctly, and we would take responsibility for not having guided the team adequately.

After that, we would ask for their help. We would invite them to design a plan that would facilitate both patient care and their training. As part of the plan, each student had to present a brief summary of their patients during rounds, instead of just filling out charts.

When the team is part of the plan, they own the outcome

The reaction was as expected: surprise, some initial resistance. But when they saw that it wasn't about imposing rules, but about giving them responsibility and a voice, everything changed. They got involved, began to communicate better, and for the first time felt that they were also leaders for their patients.

The solution was not authoritarian. We did not conduct audits or threats. We gave them context, purpose, and an active role.

Clinical leadership: teaching values before rules

It would have been easy to gather them, blame them, and dictate rules. But they were students. And if we want to train good professionals, we must first teach values, not just tasks.

Every complex situation in a team is an opportunity to ask ourselves:
What responsibility do I have in this? How can I help correct it?

Practical advice for leaders of private clinics and healthcare teams.

• Always start with why. Don't assume your team understands the importance of each task. Explain its real impact.
• Take public responsibility. If something goes wrong, show how you too have failed as a leader. That builds trust.
• Involve the team in solutions. People don't reject what they have helped build.
• Train based on values. Technical skills are learned; values are transmitted.

Final thought: there are no bad teams, only absent leaders

When you lead a clinic or a healthcare team, remember this:
you don't lead through control, you lead by example.

The next time you see dysfunction in your team, don't start by pointing fingers. First look at where you might have done something differently. Because real leadership—the kind that transforms—begins by taking responsibility.

Has something similar happened in your team? Have you found yourself in Brenda's position? Tell me in the comments or share this article with someone who might find it helpful.

Dr Mark William Hughes MRCVS CertNCS (VPM)